This country is in the midst of an opioid abuse epidemic. The day you read this article, around 130 Americans will die from opioid overdose, according to statistics from the National Institute on Drug Abuse, or NIDA. Around 47,000 Americans died in 2017 alone from opioid overdose. These deaths include overdoses from prescription opioids as well as heroin and fentanyl. The latter is a powerful synthetic opioid that is illegally created. The Annual Review of Pharmacology and Toxicology, found that over 4 percent of all adults in the United States are abusing opioids.
We consulted Dr. J. Fred Stoner, President of the Lawrence County Medical Society and board-certified physician, who specializes in pain management and pathology to share some insights on the current trends in use and abuse of opioids and other pain management substances.
History – What Went Wrong with Opioid Treatment of Pain? –
Dr. Stoner states that the crisis began when physicians were encouraged to be cognizant of their patients’ pain and actively treat their pain. According to Dr. J. Fred Stoner, another issue was that physicians were led to believe by the pharmaceutical industry that opioids such as OxyContin were not addictive. This information turned out to be false. According to Georgetown University, opioids first began to be used to treat patients in severe, chronic pain to provide them an improved quality of life. Eventually, opioids were being prescribed to patients who had only moderate or temporary pain, not just severe chronic pain.
According to statistics by NIDA, roughly 21 to 29 percent of patients who are prescribed opioids for pain management begin to abuse the substance. 8 to 12 percent of patients who are prescribed opioids become addicted.
What is Happening Today? – The Government’s Response –
According to the U.S. Department of Health and Human Services, or HHS, the government realizes that the country is in an opioid abuse epidemic. Steps are being taken to find new methods of pain management that are not addictive as well as to fund research along that avenue. Also, the government is looking into treatment options for opioid-addicted patients that include more methadone maintenance centers, increasing the number of physicians qualified to administer buprenorphine for addiction treatment, and research and development of other methods of helping people overcome their addiction. The government is also looking into ways to have first responders and others be prepared to treat opioid overdoses with drugs that stop the overdose reaction.
Dr. J. Fred Stoner believes that the government’s changes to policy in regard to pain management, going from allowing broad freedom in prescribing pain medications to stifling doctor’s abilities to make decisions on patient care and pain management today, are equally to blame with the pharmaceutical industry in culpability for the current opioid crisis.
Making OxyContin Safer Became a Stepping Stone to Heroin –
According to the Annual Review of Pharmacology and Toxicology, around 2010, OxyContin was reformulated, so that people could not crush it in order to snort or inject it. People were snorting or injecting OxyContin in order to get a more rapid and intense high. Sadly, this led to people searching for the opioid high in other ways, such as by using heroin or creating synthetic opioids, such as fentanyl.
According to the Annual Review of Pharmacology and Toxicology, today there is a 20 percent increase in heroin addiction. 80 percent of those who are using heroin today for the first time had been abusing prescription opioids. According to the Massachusetts Medical Society, another trend is opioid abuse by people who weren’t even prescribed the drugs in the first place but are misusing someone else’s prescription, possibly without their knowledge and consent.
Potential Solutions –
According to the Annual Review of Pharmacology and Toxicology, some of the potential solutions to this current crisis include surgically injecting patients with substances that block the high from the opioids. This helps addicted patients not to have to rely upon will power to end their addiction.
The Annual Review of Pharmacology and Toxicology also proposes providing more methadone maintenance programs across the country. There are currently about 900 methadone maintenance programs in the U.S. These have a high rate of success and help people live normal lives, free of addictions for years.
Dr. J. Fred Stoner, along with other pain management experts, are advocates for newer, non-addictive forms of pain management for patients with chronic pain. Dr. Stoner lauds the push in the country for medical marijuana because he sees it as a non-addictive alternative to pain management. He believes that one big problem that stands in the way of medical marijuana is that it is not a money maker for the medical industry. He is dismayed that the medical industry has changed the focus from care of patients to seeing patients as consumers that will earn them money.
Hopefully, the sheer magnitude of this crisis will allow organic, non-addictive means of helping to manage chronic pain to prevail in this country.