Addressing Both Aspects of the Opioid Epidemic

depression-824998_640If there is one thing that every human has in common, it is the fact that we can all feel pain. Recovering from a surgery or getting injured could inflict chronic pain, and when the pain gets unbearable, many people turn to opioid drugs. Opioid drugs, such as oxycodone and hydrocodone, are meant to treat moderate to severe pain. But with the rise of opioid addiction and abuse in the United States, are these drugs doing us more harm than good?

The increase of prescription opioid drug addiction and abuse, dubbed by the media as America’s “opioid epidemic,” is killing more people than we realize, and at increasing rate. By 2016, the opioid overdose death rate is 10.3 deaths per 100,000 people, compared to 1973, when opioid addiction was widespread amongst Vietnam War veterans, the overdose death rate was 1.5 deaths per 100,000 people. To put that into perspective, 59,000 to 65,000 people died of drug overdoses in 2016. In one year, drug overdoses have claimed more American lives than the amount of U.S. troops lost during the Vietnam War and Iraq War combined, which is more than 62,700 people. Drugs have claimed more lives than two wars combined.

With the opioid epidemic claiming so many lives, figuring out how to stop it has been a hot topic amongst policymakers and the general public. There are multiple proposals to stop the epidemic; some people think that the solution is to reduce the amount of opioid prescriptions, by regulating pharmaceutical companies and doctors. Others think that the main concern should be treating those who are already addicted. Instead of debating which solution is the best, we should all be advocating for both solutions to be used together.

Preventing new opioid addictions can be done by retraining doctors to change their prescribing habits; doctors tend to prescribe too much or prescribe opioid drugs when it is not necessary. Researchers from Johns Hopkins University published a report in the JAMA Surgery journal, which found that more than two-thirds of the surgery patients in the study had leftover prescription opioids. 71% to 83% of the time, the patients stated that they had not used all of their prescribed painkillers because their pain was already control.

With excess prescription painkillers, it is easy for these patients, or their family, to have access to the drugs and abuse them. Doctors should keep studies like this in mind when prescribing such drugs. If doctors fear that the patient would run out of painkillers during their surgery recovery and prescribe the amount that they would usually prescribe, they should advise patients on how to properly store and dispose the medicine. The same studies found that about 75% kept their drugs in unlocked storage and only 4% to 9% disposed or considered to dispose their leftover painkillers through methods recommended by the Food and Drug Administration. Proper storage and disposal of leftover pills prevent others from having access to and abusing your medicine.

In rural areas, the risk for opioid abuse and overdose is even higher. Alternative treatments for pain management, such as physical therapy, are limited in rural areas, so prescription painkillers are typically the doctors’ first choice in pain management. This could be addressed by creating incentives for physical therapists to set up clinics in rural areas and for doctors in small towns to seek alternative pain management treatments first.

The other step to addressing the opioid epidemic is to help those who are already addicted to prescription opioid drugs. Access to opioid addiction treatment should be made easier to come by than opioid drugs itself, and could be done so through increasing insurance coverage. Private insurers are required by law to cover mental health and addiction treatment, but most insurance companies do not cover for a long enough inpatient treatment. It is recommended for severe addicts to have about three to six weeks of inpatient treatment, in addition to outpatient treatment.

One woman, Valerie Fiore, wants the Affordable Care Act to require at least 90 days of inpatient treatment for drug addiction. Her son, Anthony, went to rehab multiple times for his heroin addiction that was caused by his Oxycontin addiction. During his last rehab visit, his mother wanted to keep him longer than his 21-day treatment, but could not afford it, since their insurance with Premera Blue Cross only covered for 21 days. Unable to pay for further treatment, Anthony had to leave rehab and died from a heroin overdose six months later. When insurance companies limit their coverage for drug addiction treatment, it could mean a death sentence for some. Valerie Fiore now mourns her son because their insurance company failed them, and so many other addicts across the country face the same problem.

In addition to inpatient stays at rehabilitation centers, we should also look to medication-assisted treatments to help opioid addictions. When most doctors notice that their patients have developed an addiction to prescription painkillers, they stop prescribing the opioids but barely offer addiction treatment. The sudden cut off of opioids and lack of addiction treatment leads most people to seek their highs through heroin.

Instead, doctors should offer medication-assisted treatment, which combines counseling and behavioral therapy with the use of substitute opiates (such as methadone and buprenorphine), which prevents cravings. The substitute opiates make withdrawal an easier process for addicts and prevents them from relapsing. Medication-assisted treatment treats both the psychological and physiological aspects of addiction, so why is it that only 10% of opioid addicts have access to it? It might be because the war against the prescription opioid epidemic is expensive, and we might not have the money to pay for it.

President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, headed by New Jersey Governor Chris Christie, is recommending that the federal government should spend billions (an unspecified amount) on medication-assisted treatment. The problem is that the White House wants to cut 95% of its funding for the Office of National Drug Control Policy, which would cut its budget from $380 million to $24 million. How are we supposed to fight the opioid epidemic if we are cutting the fund to fight it? The White House should view the funding the fight against the opioid epidemic as investment: the epidemic itself is estimated to cost the United States $78.5 billion each year. Is it not worth putting in the money now to save money, or more importantly, lives?

While we are stuck debating what is the best way to address the opioid epidemic or deciding whether or not the we should spend money to fight it, people are dying everyday from drug overdoses. We should be focused on those people, the ones that are affected by or susceptible to drug addiction. The best way to help them is to have a combination of prevention and treatment, both are equally important in the fight against the opioid epidemic. Behind all of the statistics, there are real people that struggle with addiction. And with the common use of opioid medications and everyone being susceptible to opioid addiction, you never know who will next fall victim to the epidemic.

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