Drug epidemic compare and contrast
Outline
-In 21st century, opioids are used for both medication and non-medication use.
-Opioids addiction is a global problem
-There is a higher use of drugs from opiate category
-Licit drugs is the leading cause of drug poisoning
-Prescription opioids have intrinsic abuse and euphoric effects
-Non-medication use of opioids results to heroin use
-Prescription opioids maximizes pain and adverse effects
-Opioids medication releases acute and chronic pain
-It is estimated that about 52million people use prescription opioid for nonmedical purposes
-Abuse of prescription opioid creates a pathway for heroin use
-Tennessee is among the states which have encountered adverse effects from the prescription opioid abuse
- Prescription opioid has surpassed alcohol and heroin abuse
-Prescription opioid abuse and heroin have similar adverse effects
-Prescription opioid use leads to Neonatal Abstinence Syndrome
-Patients should conduct risk assessment to avoid abuse of drugs
-Physicians should comply with state and federal laws
Thesis: prescription opioids contributes to adverse health effects and this is due to the ‘environmental availability’ created by high prescriptions, social responsibility in drug use and high trading volume with pharmaceutical companies.
Drug epidemic compare and contrast
Drug epidemic is an issue which has affected the globe in terms of health and socioeconomic welfare. In 2012, research shown that 36million people are opioids abusers in worldwide and 2.1million are affected with substance use disorder and 467,000 suffer from heroin addiction in U.S (Nora & Volkow, 2014). The trend has led to devastating effects and there have been several cases of unintentional overdose deaths. Research also shows that there is a high rate of heroin abuse and non-prescribed use of opioids. In comparing both prescribed and non-prescribed drugs, it is important to understand that both have an adverse effect on health. For instance, prescription opioids are in the medications category and they are associated with abuse liability (Nora & Volkow, 2014). The opioid analgesics and abuse problem are contributed by the high rate of written and dispensed prescriptions, high rate of marketing and use of medication for various purposes. For example, prescription of opioid pain reliever has risen from 1991 to 2013 where the number has changed from 76million to 207million respectively. The higher rate of prescription has resulted to negative consequences such as mortality. Nonmedical use of the drug has resulted to abuse and mortality, and high rate of death due to opioids abuse has increased in 21st century (Paulozzi, Budnitz &Yongli, 2006). Compared with heroin and cocaine, opioids analgesic poisoning was the leading cause of death in 2002. An important point to note is that prescription opioids have the same affects as heroin in the brain. Both have an intrinsic effect especially for non-medical purposes. Opioids abuse happens when the drug is used for non- medical use where patients purchase the drugs in the streets. For example, a research showed that over 5% of children aged 12yeras use the drug non-medically. This brings adverse effects to the economy since insurance companies are forced to pay high health-care cost and high rate of morbidity and mortality (Paulozzi, Budnitz &Yongli, 2006). Other point is that even though opioid is a prescribed medication, both drugs have are associated with overdoing risk and addictiveness. For example, fatal heroin overdoses increased by 50% in U.S from 2000s to 2010 where they raised up to 2,789. It is important to understand that there is a relationship between prescription opioid and heroin use (Paulozzi, Budnitz &Yongli, 2006). In case of heroin, the number of men and women who are heroin users has increased and overdose of heroin results to adverse effects.
However, opioid play a fundamental role in minimizing pain and suffering as well as other adverse effects. Individuals who suffer from chronic pain are prescribed opioid therapy and majority develops tolerance and physical dependence (Nora & Volkow, 2014). Mostly, physicians prescribe opioids such as OxyContin where they are attached with opioid receptor to maximize pain. The medication plays a significant role in increasing a sense of well-being. Opioid medication is good for acute and chronic pain even though many people use it for non-medical use. For example, when Oxycontin and Vicodin are taken against the doctor’s prescription, they produce similar effect with heroin (Nora & Volkow, 2014). Both have a feeling of euphoria, addiction, drowsiness, impaired breathing and other health effects. Especially when the medication is injected, it causes impaired breathing and the depressed respiration leads to hypoxia which then results to brain damage and coma. Opioid addiction also results to long-term effects such as effect on brain’s white matter and stress response (Nora & Volkow, 2014).
In discussing about drug epidemic, studies show that since 2000, deaths from opioid epidemic has estimated to be 500, 000. Note that individuals use prescribed opioids such as hydrocodone and oxycodone and nonprescription opioids (illegal drugs) like heroin. Many deaths occur when individuals take nonprescription opioid and studied show that opioid overdose caused 28, 000 deaths in 2014 (TDMHSAS, 2014). In comparing drug epidemic in terms of prescription and non-prescription, several studies show that there is a high overuse of prescription opioids. The latter is associated with serious issues in U.S and in specific in Tennessee. Studies done in Tennessee state show that abuse of prescription drug is a big problem which has brought to devastating effects to families and communities. For the past ten years, the state has combated the alcohol use and this substance abuse has affected families and communities (TDMHSAS, 2014). However, alcohol use is not ranked as the major substance use since it is surpassed by prescription opioids. Evidence on abuse of prescription opioids was achieved in 2012 through a survey which showed that individuals with heroin addiction were treated in methadone clinics. However, the survey showed that out of 9,221 individuals with heroin addiction, 78% were addicts of prescription opioid and 17% were addicts of prescription opioids and heroin and 4% were addicts of heroin (TDMHSAS, 2014). The reason for the high use of prescription opioid is because it was used as a drug of choice and for non-medical purposes.
Other important point to note on the use of prescription opioid is that individuals in Tennessee State can easily access the drug through doctor’s prescription. Others obtain prescription drugs through ‘doctors shopping’. The latter term means that patients engage in unethical behaviors where they get prescriptions from multiple physicians. After getting treatment from regular physician, they obtain more medication from other physicians. Doctors also overprescribe drugs such as psychoactive drugs where individuals use for personal purposes such treating anxiety. Given that individuals can easily access the drug, this is also an indication that there is availability of opioid drug which is a problem to the state (TDMHSAS, 2014). For example, Drug Use and Health survey which was done in 2010 showed that 70% access drugs from friends, illegitimate pain clinic, pharmacy theft, doctor shopping among other sources. Note that majority who abuse prescription opioid believe that the drugs are not associated with adverse effects compared with illicit drugs simply because they are from doctor’s prescription (TDMHSAS, 2014). However, this is not true and an important point which everyone should know is that prescription drug abuse has adverse effects to the health. For example, evidence comes from Tennessee State where individuals have lost their lives, the death has affected the economy in terms of lack of health workforce and the economy has also been affected because taxpayers’ dollars are used pay for incarceration and healthcare costs. The latter has increased in a high rate from 2005-20101.For example in 2001, the heathcare cost was $4,118,187 and in 2011, the cost increased up to $29, 308,823. Indeed, adverse effects have been counted since individuals who abuse prescription drugs engage in criminal activities where they end upon being prosecuted and incarcerated. Incarceration leads to loss of productivity (TDMHSAS, 2014). For example, loss of productivity caused a high cost to the economy which ranged from $142.9 million in 2008 to $155.2 million in 2013. Other point is that Neonatal Abstinence Syndrome is a problem which has been experienced in Tennessee where infants show withdrawal system due to exposure to illicit drugs. This result to serious medical problems and cost needed to stabilize the medical problem is $62, 973 (TDMHSAS, 2014).
Maxwell (2011) adds that abuse of prescription opioid has been a big problem in USA and the epidemic has been contributed by factors such as inappropriate prescription, easy accessibility of the drug, lack of collective actions from the government and aggressive marketing by pharmaceutical companies. There has also been a problem in pain management and this has made clinicians to increase opioid prescription for analgesia. To address this problem, OxyContin® was introduced to manage ‘non-malignant pain’ and minimize the abuse of prescription opioid (Maxwell, 2011). However, companies started to introduce methadone since it was cheap that OxyContin®. Nevertheless, prescription of methadone was done by trained and untrained physicians and this led to high mortality due to inappropriate prescription and failure to follow standard practices. In addition, public health officials failed to provide accurate information regarding the use of opioid prescription. Thus, the high epidemic has been brought by the high use of prescription opioid and this deteriorated from 2000 to 2009 where the total number of prescription from retail pharmacy was 174.1 million to 256.9 million respectively (Maxwell, 2011). It is predicted that if the abuse of prescription opioid and drug diversion continues, clinicians will not be able to prescribe extended-release opioids for main management and this is an indication that they will not be able to manage or treat pain. To address these problems and prevent future problems, patients should conduct risk assessment, there should be an informed consent periodic review and clinicians should comply with state and federal laws. In drug diversion, there should a coordinated approach through treatment programs and medical agencies in order to reduce deaths and ensure to prescription of drug to legitimate needs (Maxwell, 2011).
A report from National Institute on Drug Abuse (NIDA) states that nonmedical use of prescription drug creates a big problem to the community given that 52million people take prescription drugs for nonmedical purposes. NIDA states that majority of abusers are young people and evidence is derived from a survey which was conducted in high school in 2010.The survey showed that 1in 12 abused Vicodin and 1 in 20 abused OxyContin. The abuse of prescription drug causes addiction and death. In comparing prescription opioid and non-prescription drug, NIDA states that people who abused prescription opioid rarely take heroin. Only less percent engage in heroin use and this is evidence from National Survey which showed that less than 4% of prescription opioid abuse used heroin within 5years National Institute on Drug Abuse (NIDA, 2014). However, it is important to note that prescription opioid abuse is a pathway to heroin abuse. The evidence for this is derived from the fact that opioid medication such as OxyContin has similar effects with heroin and abuse of prescription opioid leads to heroin abuse. Recent survey showed that majority of young people who abused heroin had once been involved in the abuse of prescription opioids. They shift from prescription opioid to heroin since the latter is easy to access and it is cheap (NIDA, 2014). Patient should understand that opioids can cause drowsiness, breathing problems and other adverse health effects depending on the abused amount. On the same note, opioid can serve the intended purpose such as pain relief if it is used as prescribed by the doctor. However, abuse of prescription opioid cause brain damage since stimulants in opioid are able to act on neurotransmitter similar to illicit drugs like heroin (NIDA, 2014).
Reference
Nora D. & Volkow, M.D. (2014). Prescription Opioid and Heroin Abuse. National Institute on Drug
Abuse(NIDA).
Retrieved from: https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/prescription-opioid-heroin-abuse
Paulozzi J. Leonard, Budnitz S. Daniel &Yongli Xi MS. (2006). Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiology and Drug Safety, 2006; 15: 618–627.
Retrieved from:https://www.michigan.gov/documents/mdch/Increasing_Deaths_from_Opiod_Analgesics_in_US_339168_7.pdf
National Institute on Drug Abuse (NIDA). (2014).Drug Facts: Prescription and Over-the-Counter Medications. Retrieved from: https://teens.drugabuse.gov/sites/default/files/drugfacts_rx_12_2014.pdf
Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS). (2014).
PRESCRIPTION FOR SUCCESS: Statewide Strategies to Prevent and Treat the Prescription Drug
Abuse Epidemic in Tennessee. Retrieved from: https://www.tn.gov/assets/entities/behavioral-health/sa/attachments/Prescripti
MAXWELL, J. C. (2011). The prescription drug epidemic in the United States: A perfect storm. Drug &
Alcohol Review, 30(3), 264-270. doi:10.1111/j.1465-3362.2011.00291.x
