What is the US government’s opioid crisis response? Nearly 70% of drug overdose deaths in the United States involved an opioid in 2018, according to the Centers for Disease Control and Prevention (CDC).1 These and other staggering statistics are why the United States government has launched it’s opioid crisis response.
The need for an opioid crisis response isn’t a new occurrence. According to National Public Radio, the first opioid crisis in the United States took place in the 1800s.2 During this time, scientists discovered morphine as a painkiller. The drug was shipped overseas to the United States where wartime doctors and medics used the drug to treat soldiers fighting in the Civil War.2
Unfortunately, many soldiers returned home addicted to the drug. And in the early 1900s, morphine addiction became more common in women than men.2 Doctors prescribed the drug readily to women to treat all manner of conditions, from coughing to menstrual cramps.
Researchers created new alternatives to morphine, which were ideally designed to treat pain in safer and more effective doses. Unfortunately, the new lab-made forms have proven just as addictive as earlier forms.
While opioid abuse may not be a new problem, it’s a growing problem. In 2016, an estimated 11.5 million Americans reported misusing prescription opioids at some point in the past year, according to the CDC.1
It’s not uncommon to hear people refer to all painkillers as opioids or opiates – a lot of people use them interchangeably. Technically, there are some key differences between opioids and opiates.1
Opiates are substances created from an opium poppy. They aren’t made in a laboratory. Heroin made from opium poppies is an opiate. However, some heroin manufacturers make aspects of the drug in a laboratory. Morphine is another opiate example – it’s derived from opium poppies.
Opioids have at least some portion that’s manufactured in a laboratory. They’re chemically very similar to “natural” opiates.
Most people will call all painkilling medicines that are either lab- or naturally derived as opioids. Only a smaller subset of these medicines is truly opiates. However, both are addictive and potentially dangerous if used other than how a doctor prescribes.
An opioid overdose occurs when too much of the drug is taken. The drug causes changes in the brain that can prevent someone from breathing. As a result, there is oxygen loss to the brain, heart, and other key areas of body functioning. Without oxygen, you can’t live. Fast intervention is vital for preventing death.
There is a treatment for opioid overdose – a medication called naloxone (Narcan). This medicine is available in injectable or inhaled form. During an overdose, this medicine will displace the opioid molecules on the brain. It works very fast to help a person “wake up” and start breathing again.
Even if you give Narcan to someone overdosing, they’re still in danger. Some opioids last longer than the Narcan does. Once the Narcan wears off, the person could stop breathing again. That’s why people who’ve overdosed should still seek medical attention.
It’s important to understand that opioid addiction can have many factors that contribute to its occurrence. Some people may get a prescription from their doctor after an injury or surgery and start to build up a tolerance, where they find they must take more and more to relieve pain. They may become physically dependent on the medication, where they have withdrawal symptoms if they suddenly stop taking it.1
Others may use opioids recreationally – this may include getting high. They may take them with alcohol or benzodiazepines (like Xanax, Valium, or Ativan) to enhance the high.1 This can easily result in an addiction to opioids. If they keep using them, they may become physically dependent as well.
A substance use disorder is when a person loses control of how much or how often they use a particular substance.3 A substance use disorder is different from dependence. A person (such as a cancer patient) may become dependent on an opioid to relieve their pain. They’ll have withdrawal symptoms if they stop using the drug.
However, it’s the lack of control over the substance abuse that results in a disorder.3 Often, with opioids, after regular abuse, changes start to occur, such as:
Lack of motivation
Thinking about the drug more and more
Having trouble getting the drug and potentially engaging in illegal behaviors to get it
Having financial or legal problems due to their drug use
Ultimately, a person who is addicted to opioids may feel like they can’t face their life without opioids.
Many people mistakenly believe that if a person wants to stop abusing drugs, they should be able to mentally decide to stop and failure to stop is a choice. This isn’t the case. Addiction to opioids can take hold from a physical and mental perspective. Changes occur in the brain result in the chronic search of opioids, even if the drugs are possibly killing them.
Because opioid addiction is a longer and more well-known addiction in the United States, doctors have more research about the opioid crisis response. Some of the opioid crisis response approaches include.
A doctor can prescribe medications like methadone or Suboxone as an alternative to using opioids illegally. These medications can help to relieve pain, but don’t create the same “high” that illegal opioids can. If a person participates in these programs, they must participate in regular monitoring programs.
Behavioral therapy is important in helping a person understand more about addiction and its effects. The therapy also helps a person identify their reasons for becoming addicted and their motivations. Participation in support groups can also help teach techniques to overcome addiction.
Harm reduction is a somewhat newer concept in opioid addiction treatment.4 It’s more popular in Europe, where countries are offering “safe” injection facilities, where a person can come and receive clean needles and inject drugs in a monitored environment. While some argue this approach enables addiction, it also de-stigmatizes people with addiction and provides safer approaches that don’t have as many long-term effects (such as getting HIV or hepatitis from using dirty needles).
Another harm reduction strategy is making naloxone available without a prescription. People who are at risk for overdose can obtain naloxone, which a loved one can use should a person experience an overdose. Some states will also offer syringe exchange programs where participants can obtain clean syringes to reduce disease transmission.4
Research into the opioid crisis response reveals there are many responsible for increasing the risks of addiction – this includes prescribing policies, pharmaceutical advertising, and an emphasis on pain management in reimbursement for hospitals and healthcare facilities, among others.
While many private organizations are fighting the epidemic, so is the federal government.
$900 million in funding to the CDC to distribute to states, territories, and local governments
$932 million to individual states and local communities that is administered by the Substance Abuse and Mental Health Services Administration
Data from 2017 and 2018 have revealed the early efforts in improving the opioid crisis response have shown promise. Examples include increases in buprenorphine prescriptions (28%) and naltrexone prescriptions (55%) since President Trump took office.5
These are two most common medications that doctors prescribe to reduce opioid use.
In addition, from 2017 to 2018, the number of drug overdose deaths decreased by 2.8%.5
The Opioid Crisis Response Act of 2018 is an example of legislation specifically aimed at treating opioid addiction. Examples of some of the stipulations around the act include:6
|Funding to the National Institutes of Health to promote research for new, non-addictive painkillers|
|Funding to the FDA to promote safe disposal symptoms, coordinate with Customs Border Protection, and aid in the development of new non-narcotic pain medications.|
|Training for first responders in treating overdoses.|
|Increasing education materials for those of all ages, including on neonatal abstinence syndrome|
The opioid crisis response effects were furthered by a subsequent Act in 2019.
Top executives can be held criminally liable for false and misleading advertising
Increased penalties for drug manufacturers who illegally advertise, market, or distribute opioids
Pharmaceutical manufacturers must reimburse the government for the negative economic impact their drugs produced
To date, the act has been stuck in subcommittees and hasn’t been passed. Sadly, time and research have revealed some drug manufacturers mislead and were aware that their products were highly addictive. Were this information available earlier, the opioid crisis response could have been launched much earlier. Ideally, by holding manufacturers accountable, they are less likely to engage in these misleading practices in the future.
Preventing people from taking pain pills in the first place is one method doctors are using to try and reduce the opioid epidemic.1 Examples include using non-opioid approaches to pain management, such as taking non-steroidal anti-inflammatory drugs, using pain blocks with local anesthesia, and using alternative methods, such as aromatherapy, massage, heat, cold, or other soothing approaches.
An estimated 128 people in the United States die every day from an opioid overdose, according to the CDC.
According to the CDC, the current opioid epidemic has occurred in three “waves”:8
Wave 1: Prescription opioid overdose deaths started to increase in 1999 and steadily increased until 2011.
Wave 2: Researchers saw an increase in heroin deaths starting in 2010.8 While there may be many reasons for this, some people believe that when the government started making prescription opioids less available, people started to turn to heroin.
Wave 3: Wave 3 started in 2013 when researchers identified an increase in synthetic opioid deaths. These are often powerful medications like fentanyl that are made in illegal labs. Because they’re so strong, people are more vulnerable to overdose.
There is still a long way to go in the opioid crisis response, but treatment methods and educational efforts are showing improvement.