The opioid epidemic has been a major public health crisis in the United States in recent years. According to the Centers for Disease Control and Prevention (CDC), more than 70,000 people died from drug overdoses in 2019, with opioids being involved in over 46,000 of those deaths. This article will explore the trends in opioid deaths in the US, particularly in relation to prescription trends, and suggest ways in which doctors can help to address this crisis.
Opioids are a class of drugs that include prescription pain relievers such as oxycodone, hydrocodone, and morphine, as well as illicit drugs such as heroin and fentanyl. Prescription opioids have been heavily prescribed in the United States for decades, contributing to the rise of opioid addiction and overdose deaths. The 1990s saw a push to treat pain more aggressively, leading to an increase in opioid prescriptions. Pharmaceutical companies marketed opioids as safe and effective painkillers, contributing to the surge in opioid use.
However, in recent years, there has been a shift in prescribing practices. Doctors are more cautious about prescribing opioids, and many have implemented new prescribing guidelines to reduce the risk of addiction and overdose. According to a study published in the New England Journal of Medicine, the number of opioid prescriptions written by doctors decreased by 43% between 2012 and 2017.
Despite these efforts, opioid-related deaths continue to rise. One reason for this is that many people who become addicted to prescription opioids turn to illegal opioids, such as heroin and fentanyl, when their prescription runs out or becomes too expensive. In fact, the CDC reports that over 70% of opioid overdose deaths involve synthetic opioids like fentanyl.
The rise of fentanyl has been a major contributor to the opioid epidemic. Fentanyl is a powerful synthetic opioid that is 50-100 times more potent than morphine. It is often mixed with other drugs, such as heroin or cocaine, without the user’s knowledge, leading to accidental overdoses. A study published in JAMA Network Open found that the increase in fentanyl-related deaths accounted for 55% of the overall increase in opioid-related deaths from 2013 to 2016.
Another factor contributing to the opioid epidemic is the overprescribing of opioids for acute pain. A study published in JAMA Surgery found that patients who received opioids after surgery were more likely to become long-term opioid users. The study recommended that doctors explore non-opioid pain management strategies for acute pain, such as nerve blocks and acetaminophen.
Doctors can play a key role in addressing the opioid epidemic by implementing responsible prescribing practices and exploring alternative pain management strategies. The CDC has issued guidelines for prescribing opioids for chronic pain, which include prescribing the lowest effective dose for the shortest duration possible and monitoring patients for signs of addiction and overdose. Additionally, doctors can work with patients to explore non-opioid pain management options, such as physical therapy, cognitive behavioral therapy, and non-opioid medications. CME Vacations offer an online Opioid Prescribing and Pain Management CME course for $69.
Another way in which doctors can help to address the opioid epidemic is through medication-assisted treatment (MAT). MAT combines medication, such as buprenorphine or methadone, with counseling and behavioral therapies to treat opioid addiction. MAT has been shown to be an effective treatment for opioid addiction, reducing the risk of overdose and increasing the likelihood of successful recovery.
It is also important for doctors to be aware of the signs of opioid addiction and overdose. These can include drowsiness, confusion, small pupils, slowed or shallow breathing, and blue or gray lips and nails. If a doctor suspects that a patient is struggling with opioid addiction, they should refer them to a substance abuse specialist for further evaluation and treatment.
The opioid epidemic in the United States is complex and has many factors; clearly increased prescribing helped fuel the opioid epidemic, but decreased prescribing is not slowing it down.