The United States is in an opioid epidemic. In 2017 in the United States, the number of overdose deaths involving opioids, including prescription opioids, was six times higher than it was in 1999. Every day, an average of 130 people in America die from an opioid-related overdose, according to the Centers for Disease Control and Prevention (CDC).
The CDC describes three waves in the opioid epidemic. The first wave began in the 1990s, with increasing opioid prescriptions. The second wave started in 2010, and there was a rapid increase in overdose deaths related to heroin. In 2013, there was a third wave, which involved increases in deaths related to synthetic opioids like fentanyl.
Because of the devastating effects of the opioid epidemic, many people have a negative perception of these drugs. At the same time, opioids are still prescribed and do have useful applications in medicine.
Recently, Advanced Recovery Systems conducted a survey to learn more about people’s understanding and perception of opioids. Of the 400 respondents, the largest majority were aged 25 to 34. There were also respondents from other age brackets, and all respondents were from the United States. Approximately 60% of survey respondents were female, and 40% were male. Of the survey respondents, the vast majority (95.25%) said they’d heard of opioids and opiates.
One of the most interesting components of the study was that of the respondents, 51% said they perceived opioids negatively. Only 12.25% had a positive perception of opioids. The numbers were similar when respondents were asked about opiates instead of opioids.
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Opioids and Pain
Around 74% of people responding to the ARS survey said they believed these drugs are used both medically and recreationally. Only 17.75% of respondents said opioids are only used medically.
How Are Opioids Prescribed?
Prescription opioids are used as a treatment for both chronic and acute pain. According to the CDC, when used appropriately, they can be an important component of treatment. Opioids are used for the treatment of severe cancer pain, and in situations where someone may be tolerant to other pain medications.
Sometimes opioids are used for the treatment of chronic pain also. The CDC reports that as many as 1 in 4 patients who receive long-term opioid treatment in primary care settings struggle with an opioid use disorder. CDC doesn’t recommend opioids as the first-line treatment for chronic pain unless there aren’t other options, and the benefits of opioids outweigh the possible risks. In 2017, the CDC’s data shows more than 17% of Americans had at least one opioid prescription filled. There were almost 58 opioid prescriptions written for every 100 Americans, and the average number of days per prescription continues to increase.
Limits on Prescribing
There have been calls for limits on prescribing opioids in the United States. With the CDC’s prescribing guidelines, there are other recommendations aside from avoiding opioids as the first-line treatment. The CDC guidelines recommend the use of non-medication-based therapy, particularly for chronic pain, or non-opioid pharmacologic therapy.
The CDC goes on to advise that if opioids are used, they should be combined with non-opioid medications or non-medication treatment whenever possible. Non-medication treatments for pain can include exercise therapy, weight loss or behavioral treatment like cognitive behavioral therapy.
While some say having these kinds of guidelines in place and limiting the use of opioids can curb the epidemic in the U.S., others worry it will keep people with legitimate pain from getting adequate treatment.
Understanding the Risks of Opioids
Regardless of whether someone believes there should be further limits on opioid prescribing or not, most can agree that having an understanding of the risks of opioids is essential when these medications are prescribed. Some of the possible risks of opioids, even when they’re prescribed, include:
- Overdose: There are serious risks of overdosing, even with prescription opioids. Opioids slow the central nervous system. When someone takes a dose that’s too high or combines an opioid with another substance, such as Xanax or alcohol, they are at risk of overdosing because their breathing slows too much.
- Addiction: Addiction occurs when opioids trigger the brain’s system. Opioids can cause people to feel high, and the brain’s reward system can then be triggered, leading to an addiction.
- Dependence: Dependence can occur with or without addiction. When someone exposes their body and brain to opioids repeatedly, they may become physiologically dependent on them. If someone has an opioid dependence and they suddenly stop using them, it can lead to withdrawal symptoms.
Do the Benefits Outweigh the Risks?
When survey respondents were asked whether they think opioids and opiates are good for society, nearly 52% said they play both a positive and negative role. More than 31% said they only play a negative role, and only 10.5% of survey respondents said they play a positive role only.
This can represent the fact that most people do feel that opioids have a role in medicine, but also that the risks and downsides of these drugs need to be fully explored and patients need to be better informed.