Addressing the Opioid Epidemic

“The year 2017 saw over 70,000 overdose deaths in America.”According to the novel Opioid use disorder: A Holistic Guide to Assessment,Treatment, and Recovery by Charles Atkins. “ Over 70% of those who become opioid dependent begin with prescription pain medications, either prescribed (about 30%) or obtained from friends and family (over 40%). Americans consume over 90% of the worlds pharmaceutical opioids with enough prescriptions written annually for everyone to have at least one bottle.” The opioid epidemic is a serious problem, and those deaths just keep increasing each year. According to the World Health Organization “Opioids are psychoactive substances derived from the opium poppy.” Opioids affect the body and can be harmful, they can cause a dependence to the drug, and can be dangerous if used during pregnancy.

Opioids are created to replicate the pain reducing properties of opium, and they can include legal painkillers as well. Due to the effect opioids have on the part of brain that regulates breathing an overdose can lead to respiratory failure. Depending on the type of opioid there can be several side effects to certain parts of the body. Chronic use of opioids can lead to the development of hyperalgesia, which is a syndrome of increased sensitivity to pain. Abuse of opioids can also be associated with psychomotor impairment, which can overall slow down a person’s physical movements and cause a loss of coordination.

Not only can opioids have an effect on ones nervous system, but they can also affect the respiratory system. Overdosing on opioid painkillers can lead to respiratory depression, which is a slowing of breathing. This can cause respiratory arrest, and can deprive the brain of oxygen, which can be very dangerous and fatal. Furthermore opiates can damage ones digestive system. According to Drugabuse.com “Opiates affect the muscles of the digestive system, leading to constipation due to a slowing of digestive transit.” Chronic constipation, can put people at heightened risk for small bowel obstruction, perforation and a serious infection in the abdomen which is called peritonitis.

Opiates can affect ones liver greatly, especially when combined with acetaminophen. Excessive use of drugs can cause the liver to damage from the acetaminophen toxicity. According to Drugabuse.com “Damage to the liver from acetaminophen toxicity is an undeniable risk of taking excessive doses of many prescription painkillers such as Lortab, Norco and Vicodin”. Many opiate users drink alcohol, liver function is impaired and damaged. This decreases the liver’s ability to process the combination of these two substances.

Most importantly, opioids can be harmful to the brain. Opiate painkillers have side effects such as daytime sleepiness. An example of an opioid that is harmful to the brain is heroin. Using this drug excessively can cause someone to slip in and out of consciousness. If on painkillers for a long period of time, patients can be at a heightened risk for developing depression. According to Drugabuse.com, “Patients using painkillers in excess of six months had more than 50 percent greater chance of developing a depressive episode.

Subsequently, opioids can affect one’s body by its opioid receptors. There are several types, for example: Delta receptors produce analgesia which enhances mood, anxiety, and depression. Another one is Kappa receptors which induce analgesia, that is associated with emotional changes, like sadness. An additional component to opioid addiction is dependence. Dependence occurs when an individual stops the substance within an expected amount of time, resulting in the person experiencing a withdrawal symptom. The feeling of withdrawal is usually a serious case of the flu and emotional distress. Some common signs and symptoms of opioid withdrawal are rapid breathing and sweating.

Not only can someone develop a dependence but also a tolerance to opioids. According to Charles Atkins in his novel (Opioid Use Disorders: A Holistic Guide to Assessment, Treatment, and Recovery) he states, “Tolerance is a major cause of progression in patterns of usage.” Most people start by just taking pills, and then escalate to snorting, or injecting themselves with needles. To feel some type of pain relief the person takes higher doses to get the same effect, which causes them to develop a tolerance to the drug. According to an article from CNN, opioids “activate reward areas of the brain by releasing the hormone dopamine, creating a feeling of euphoria or a “high”’. Dopamine is a neurotransmitter, which in oftentimes is referred to as the “reward system” or also known as the mesolimbic pathway. In Opioid Use Disorder: A Holistic Guide to Assessment, Treatment, and Recovery it states “Once bound to these receptors, dopamine is released, and we experience euphoria and other pleasurable arousal, and diminished anxiety and depression. In time, what starts as a learning process, “Gee, snorting oxycodone feels awesome,” creates cellular (synaptic) changes to where the snorting of oxycodone is a hardwired memory.” Clearly, the effects on the brain can be highly influenced by opiates.

Even though in some cases opioids are prescribed to women during pregnancy, there are still several risks and it can be dangerous not only to the mother but to the unborn baby. Some opioids that pregnant women are prescribed are pain relievers like, oxycodone, hydrocodone, fentanyl, and tramadol. Furthermore Neural tube defects can occur, which is a birth defect of the brain, spine, and spinal cord. Preterm delivery and miscarriage are possible, and even stunted growth which leads to low birthweight. Not using the prescribed doses can be very harmful to the fetus. Lastly, the baby can have Neonatal abstinence syndrome (NAS), which happens when a baby is exposed to a drug from within the womb before being born and undergoes a withdrawal from the drug after being born. “NAS can cause serious problems for a baby, like being born too small and having breathing problems.” (March for Dimes)

Babies who are exposed to opioids before being born are also at risk for birth defects. Some birth defects include heart defects and spina bifida.“Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works.” (March for Dimes). Spina bifida is one of the most common neural tube defects in babies who are exposed to opiates. More so that it is highly recommended to not stop taking opiates while pregnant. If someone was to stop they could risk placental abruption, which is when the placenta separates from the wall of the uterus before birth. The placenta can either separate partially or completely. This occurs when the placenta ruptures and causes heavy bleeding and can be life threatening to both the mom and baby. This is a serious condition because the placenta supplies the baby with food and oxygen through the umbilical cord.

Most people get addicted to opioids after being prescribed to it. “The majority of people with opioid use disorders use prescription pills. This speaks to the truism that opioid use disorders start in the medicine cabinet and not on the street.” (Opioid Use Disorder: A Holistic Guide to Assessment, Treatment, and Recovery By: Charles Atkins). This is very alarming, and proves that the opioid epidemic in the United States basically stems from prescribed pain killers. According to the book Opioid Use Disorder, the people who had the highest rates of death were in the ages 25-34, 35-44, and 45-54. Another group of people that are put at high risk for an opioid use disorder are people with mental health problems. People who are prescribed opiates for an injury are at heightened risk because they are given strong medication for pain relief. Young adults prescribed opiates before the age of 18 are at high risk for opioid disorders as well.

People dependent on opioids are most likely to suffer from an overdose. According to World Health Organization, “Because of their capacity to cause respiratory depression, opioids are responsible for a high proportion of fatal drug overdoses around the world.” Overdose deaths have increased due to them being prescribed for chronic pain. People are given these opioids to control their pain, from their doctors but after the dosage is up people can become very addictive. Over the years deaths have increased because doctors are recommending them to patients, and more and more people are being exposed to opioids.

To conclude, the deaths from opioids continue to rise each year. They are very harmful to the body, and taking them in excessive amounts and lead to death. Opioids affect the brain, respiratory system, digestive system, the nervous system, and the liver. People who are on opiates can later develop a tolerance and a dependence which can be dangerous. Not only are opiates dangerous to people of practically all ages, when taken in large amounts. But can also be dangerous when prescribed to pregnant women. They cannot only be harmful to the mother but to the baby as well. There are several risks when taking opioids and can easily be fatal if not careful. Opioids are a very serious problem in the United States, and those drugs can even be in your medicine cabinet.

Bibliography

1. Atkin, Charles “Opioid Use Disorder: A Holistic Guide to Assessment, Treatment, and Recovery” PESI Publishing & Media
2. https://www.cnn.com/2017/09/18/health/opioid-crisis-fast-facts/index.html
3. CNN Library, April 11, 2019
4. https://drugabuse.com/featured/the-effects-of-opiates-on-the-body/
5. https://medlineplus.gov/opioidabuseandaddiction.html
6. https://medlineplus.gov/pregnancyandopioids.html
7. https://www.who.int/substance_abuse/information-sheet/en/

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