A look into opioid abuse

shutterstock_233165680The recent death of Prince has put opioid abuse in the headlines. The music superstar was known to deplore drug and alcohol abuse, but he died of an accidental overdose of the powerful painkiller fentanyl. (Speculation is that Prince had endured serious hip injuries from decades of energetic performances, and the chronic pain led to the use of painkillers.) Fentanyl is also to blame for a rash of deaths in California this year involving teenagers.

As with so many drugs, improper use of opioids can lead to addiction problems. And the potency of opioids can lead to tragic results. Here’s a look at opioid abuse.

What are opioids?

The National Institute on Drug Abuse describes opioids as painkillers such as hydrocodone (Vicodin), oxycodone (Percocet, OxyContin), morphine and codeine: “Hydrocodone products are the most commonly prescribed for a variety of painful conditions, including dental and injury-related pain. Morphine is often used before and after surgical procedures to alleviate severe pain. Codeine, on the other hand, is often prescribed for mild pain.”

Fentanyl, the opioid that Prince overdosed on, is described as “the most potent narcotic known,” in a recent story by Reuters. The U.S. Centers for Disease Control calls fentanyl “50 times more potent than heroin and 100 times more potent than morphine.”

The effects

Proteins known as opioid receptors are in the brain, spinal cord and other organs, according to the NIDA. Opioids attach themselves to those receptors, which reduces the “perception of pain.” Other effects include drowsiness, nausea and mental confusion, the NIDA states, along with “depressed” respiration, depending on how much of the drug is used:

“Some people experience a euphoric response to opioid medications, since these drugs also affect the brain regions involved in reward. Those who abuse opioids may seek to intensify their experience by taking the drug in ways other than those prescribed. For example, OxyContin is an oral medication used to treat moderate to severe pain through a slow, steady release of the opioid. People who abuse OxyContin may snort or inject it, thereby increasing their risk for serious medical complications, including overdose.”

The statistics

How widespread is opioid use? Here are some NIDA estimates from the Senate Caucus on International Narcotics Control in 2014, and from the CDC.

  • Between 26 million and 36 million people abuse opioids around the world.
  • 1 million people in the United States have opioid abuse problems.
  • The number of unintentional overdose deaths from prescription painkillers quadrupled since 1999.
  • In 2014, more people died of overdoses than any previous year. More than six out of 10 overdose deaths that year included an opioid.
  • 78 people in the U.S. die each day from opioid overdoses.

Prevention

As we’ve seen with illegal drugs, it’s likely not possible to eliminate the opioid problem. There will continue to be a need for legitimate uses of painkillers under the right medical circumstances. But the CDC notes that improvements must be made in the prescription process:

  • “Improve opioid prescribing to reduce exposure to opioids, prevent abuse, and stop addiction.”
  • “Expand access to evidence-based substance abuse treatment, such as Medication-Assisted Treatment, for people already struggling with opioid addiction.”
  • “Promote the use of state prescription drug monitoring programs, which give health care providers information to improve patient safety and prevent abuse.”
  • “Implement and strengthen state strategies that help prevent high-risk prescribing and prevent opioid overdose.”
  • “Improve detection of the trends of illegal opioid use by working with state and local public health agencies, medical examiners and coroners, and law enforcement.”

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