Amazing that there are many opioid epidemic solutions, but the epidemic continues to worsen. This article explores how we got here and current trends. Also, the solutions to prevent opioid abuse, mitigate the harms, and solutions to reclaim opioid-dependent addicts.
“Happiness is not to be found at the bottom of a bottle or from the tip of a needle; it is not to be found admist a cloud of smoke or within a sugar-coated pill. If you look for it in these places, you will find naught but despair.”Wayne Gerard Trotman
Opioid Epidemic Solutions – How We Got Here And What Will Happen If We Continue On Our Current Track.
The opioid epidemic is a public health crisis of epidemic proportions. Surprisingly, it affects people of all ages, genders and backgrounds. Still, it is most rampant among young people. Furthermore, the crisis is fueled by the availability of opioids and the ease with which they can be obtained. To detail, below is a definitive definition of opioids and what it encompasses. Also, some startling facts on America’s opioid epidemic.
What Are Opioids?
Opioids are a class of drugs used to reduce pain. Specifically, these opioids can be divided into 3 types:
Prescription Opioids. Prescription opioids can be prescribed by doctors to treat moderate to severe pain but can also have serious risks and side effects. Common types are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone.
Fentanyl. Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. Illegally made and distributed fentanyl has been on the rise in several states.
Heroin. Heroin is an illegal opioid. 36 people die every day from an overdose death involving heroin in the United States.”CDC
The quote below sums up what devastation the opioid epidemic has caused to ravish America in the last few decades.
“Since 1999, more than 600,000 people in the U.S. and Canada have died of an opioid overdose, exceeding the mortality rate of the worst of the HIV/AIDS epidemic, the report says. … estimates of the epidemic’s financial costs have reached $1 trillion. During 2021, fatal drug overdoses spiked in the two nations, reaching 100,000; 70,000 alone were opioid-related deaths in the United States.”Stanford-Lancet Report
What Will Happen If Current Trends Continue?
Over the decades we have implemented many, many solutions to eliminate the opioid epidemic with limited success. In fact, the epidemic keeps on getting worst, and will continue to worsen if trends continue. To enumerate, see the quote below:
“The commission’s model projects that, from 2020 to 2029, opioid deaths will total 1.22 million in the U.S. if no new action is taken to address the epidemic.”Stanford-Lancet Report
“Under drugs you do not find yourself, but only your shadow.”Konstantin Wecker
Prevent Opioid Abuse – The First And Best Of The Opioid Epidemic Solutions.
Prevention is key to addressing the opioid epidemic. Indeed, it is important to raise awareness of the dangers of opioid use, and to take steps to reduce the availability of opioids, particularly to youth. Specifically, this can include increasing education about the risks of opioid use, restricting access to opioids, and increasing access to treatment options for those who are already dependent.
Prevention is the best solution to the opioid crisis. Further, everyone in the community has a role to play in prevention. Specifically, this includes law enforcement, education, public health, physicians, pharmacists, community organizations, courts, legislators, and family members. More importantly, the individual who is taking opioids or who is at risk of abusing opioids has a role to play in preventing opioid abuse. Undeniably, everyone who comes in contact with opioids can have a positive or negative influence on opioid abuse. Further, below are four specific actions that communities can take to prevent opioid abuse:
1. Reduce Supply.
- Prescriptions. Decrease the supply of prescription opioids by changing prescribing and dispensing practices, preventing diversion, and limiting pharmaceutical production.
- Illegal / Recreational. Decrease the supply of recreational opioids by classifying overdose deaths as crimes, changing the classification of controlled substances, and arresting and prosecuting dealers.
2. Reduce Demand.
Decrease the demand for recreational opioid use by implementing drug courts, eliminating pre-authorization for substance abuse treatment, and building a strong recovery system. Although some of these solutions are after the fact, they will still result in reduced demand of opioids through more effective deterrence of potential abusers as well as the effective recovery of abusers.
3. Alternatives To Opioids.
Increase the availability of non-opioid forms of chronic pain management by changing reimbursements for pain management drugs and increasing the availability of non-opioid treatments.
Educate the public about the risks of prescription opioids by identifying patients at greater risk for addiction. Also, provide educational resources on all aspects of the dangers of opioids.
For more information of how to prevent opioid abuse, see HealthAffairs’ A Systems Approach Is The Only Way To Address The Opioid Crisis
Mitigate The Risks Of Opioid Use.
“Drugs are a waste of time. They destroy your memory and your self-respect and everything that goes along with your self-esteem.”Kurt Cobain
In addition to prevention, it is also important to mitigate the risks of opioid use. Specifically, this can include increasing access to naloxone, which can reverse the effects of an opioid overdose. Additionally, providing access to medication-assisted treatment for those already dependent on opioids. Also, it is important to ensure that those who are prescribed opioids are properly educated about the risks. Lastly, better monitoring for signs of addiction.
Again, mitigating the harms of opioid use is no substitute for preventing abuse first. However, these mitigation solutions can reduce illness, injury, and death within the community. To mitigate the risks of opioid use, consider the following three solutions:
1. Prevent Death From Opioid Overdose.
Administer Naloxone to reverse the effects of an overdose, increase the availability of Naloxone in the community, and educate family/friends on signs of overdose and use of Naloxone. Additionally, make Naloxone available to recently released prisoners and detox patients, who are 40 times more likely to die of overdose.
2. Create Learning and Feedback Loops.
Report opioid overdoses to any provider linked to the individual. Also, provide access to the Prescription Drug Monitoring Program (PDMP), and use PDMP at each patient encounter.
3. Make Available Needle Exchange.
Clean needles reduce the risk of HIV and Hepatitis C. Additionally, link drug users with vital health care services. Lastly, needle exchange programs can also connect individuals with opioid use disorder to treatment services.
For more ideas and information on mitigating the risks of opioid use, see Brooking’s How do we tackle the opioid crisis? and HealthAffairs’ A Systems Approach Is The Only Way To Address The Opioid Crisis.
Recover And Reclaim Opioid-Dependent Addicts.
“We Cannot Go Back and Start Over, But We Can Begin Now, and Make a New Ending.”James R. Sherman
Finally, it is important to ensure that those who are struggling with opioid addiction have access to the resources they need to reclaim their lives. Specifically, this can include providing access to treatment, support, and recovery services. Additionally, help those in recovery to access the resources they need to reintegrate into society.
However, there is no “silver bullet” to reclaim the life of an addict. Specifically with opioids, physical addiction dependency may only last 4-8 weeks, and after the initial recovery it is a long, lifetime journey. In many cases, more than 80% of opioid addicts have a relapse within one year of treatment. Again, the best way to combat opioid abuse is to prevent it. For specific solutions to help recover and reclaim an opioid-dependent addict, see below.
1. Treat And Manage Opioid-Dependent Population.
This involves tapering patients from high dose/chronic use. Additionally, educate addicts and the community about pain management. Lastly, increase the availability and reimbursement of alternative pain management therapies.
2. Identify Opioid-Addicted Individuals.
This includes assessing for substance use (opioid use) disorder at physician visits. Additionally, use PDMP to identify opioid-seeking patients
3. Increase Enrollment in Detox And Ongoing, Comprehensive Substance Abuse Treatment.
This includes increasing the availability of inpatient and outpatient detox, training providers to use medication-assisted treatment (MAT), increasing the availability of MAT, and increasing the availability of behavioral health services.
4. Link Detox And Ongoing Treatment And Recovery Services.
This includes providing ongoing MAT when appropriate, provide ongoing group therapy, and implement drug courts.
5. Reduce Stigma.
This includes providing education for providers, individuals/families, and law enforcement. Many times, the people who could help an addict are inhibited from doing so because of the stigma attached to drug addiction. Drug addiction should not be hidden, be ashamed of, or ignored.
6. Collect Better Data / Collaboration.
To effectively help addicts recover and reclaim their lives, we need to collect and share better data on every aspect of the life cycle of addiction. Most importantly, this includes relapses and final recoveries. Unquestionably, this information will help stakeholders take specific actions to assist the addict in reclaiming their life.
“Quitting smoking is easy. I’ve done it a hundred times.”Mark Twain
For more ideas and information on solutions to the opioid epidemic, see HealthAffairs’ A Systems Approach Is The Only Way To Address The Opioid Crisis and EndTheEpidemic’s AMA Overdose Epidemic Report.
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