Opioids and the Treatment of Chronic Pain

In 2019, more than 2 Million Americans will suffer from addiction to prescription or illicit opioids. Opioids killed more than last year than either car accidents or gun violence. This crisis of addiction can affect any American, from all-state football captains to stay at home mothers. As a result, Americans, across the country are feeling the weight of the crisis next door according to (https://www.crisisnextdoor.gov)

Many have questioned what are opioids, opioids- natural or synthetic, illicit or otherwise, act on the body’s opioid receptors and all carry similarly high risks of dependency, addiction and overdose. Heroin is the most commonly known opioid, and as an illicit drug, it poses additional risks beyond simply being a powerful drug. Morphine is a well known for its use in medical contexts.

Opioids have a strong risk of addiction, meaning their use or misuse create brain changes that lead to addiction. A person who is addicted develops an overpowering urge, or cravings, for the drug. The person also experiences a loss of control and painful withdrawal symptoms, making it more difficult to refuse the drug, even when use becomes harmful. Most people who are addicted to opioids can’t use less of the drug over time without help. (https://drugfree.org)

Hydrocodone, Oxycodone, Percocet and Morphine are the commonly most misused of prescription pain relievers. Approximately 91.8 million adults aged 18 or older were past years users of prescription pain relievers in 2015, representing more than one-third of the adult population. Approximately 11.5 million adults misused prescription pain relievers at least once in the past year. They are mostly misused used because they relieve physical pain, relax or relieve tension, to experiment or see what the drug is like, to feel good or get high, to help with sleep, feelings or emotions. The main reason of the misused opioids was to relieve physical pain. From a personal experience of working in a pharmacy I see it everyday, people being addicted to such drugs and it’s mostly the older people. The elderly have such a high addiction, that they get mad when they’re unable to receive the prescription drug at a certain time of the month. Not only does it affect the elderly but it also affects people that use the prescriptions drugs for other things as well.

New Jersey developed an innovative program, the Opioid Overdose Recovery Program (OORP), to address the epidemic and the issue of low treatment admissions following a non-fatal overdose. The OORP utilizes an intervention model with peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments (EDs) immediately following an opioid overdose reversal. The purpose of this exploratory study was to examine the process through which the OORP was implemented in its first year and determine facilitators and barriers to implementation. Data were collected in 2016-2017, through 17 telephone interviews and focus groups with 39 participants. Participants were OORP staff and stakeholders selected through purposeful, non-random sampling. Standardized, open-ended interview guides were used. Thematic analysis was conducted to identify, analyze, and report overall patterns. Participants detailed stories from the field and policymakers illuminated the process of implementation. Findings revealed logistical barriers to treatment including patients' lack of insurance and cell phones, lack of immediately available detox beds, and program ineligibility for some patients due to medical conditions. The model using peers as first responders had a positive impact as their experiences with addiction enabled them to more successfully engage patients. The PNs were critical in addressing high needs for case management and referral and external partners were also important for implementation, according to the (Promoting opioid overdose prevention and recovery: An exploratory study of an innovative intervention model to address opioid abuse.)

Now to prevent future opioid addiction, assessing for and treating psychiatric and substance use disorders prior to and during use of prescribed opioids, with behavioral health provider support, can improve appropriate opioid prescribing, decrease pain, and prevent opioid misuse. Given the association of mental health conditions and prior substance abuse with opioid use disorder, and the fact that treatment of depression and PTSD can improve pain, guidelines and experts recommend a complete psychological assessment prior to initiation of chronic opioid therapy. Interdisciplinary evaluation by a behavioral health provider can support physician decision-making and decrease opioid prescriptions to higher risk patients. Psychological interventions based in cognitive-behavioral therapy addition to improving pain, may also decrease medication misuse in patients on chronic opioid therapy. Creating stricter guidelines can help prevent someone from becoming addicted and increasing the opioid abuse rate.

The main reason of the misused opioids was to relieve physical pain. The opioid epidemic isn’t one person’s problem, and so it will take everyone to beat it. Knowing the dangers, signs, and symptoms of opioid abuse can save someone’s life. Talk with your loved ones openly and remove the stigma of addiction. It isn’t something that only happens to the weak. It is a biological reaction that can happen to anyone, with or without their knowledge.

References

https://www.crisisnextdoor.gov/?utm_source=google&utm_medium=cpc&utm_term=the%20opioid%20crisis&utm_campaign=Crisis%20Next%20Door%20-%20Brand

https://www.addictioncenter.com/opiates/

Powell, K. G., Treitler, P., Peterson, N. A., Borys, S., & Hallcom, D. (2019). Promoting opioid overdose prevention and recovery: An exploratory study of an innovative intervention model to address opioid abuse. International Journal of Drug Policy, 64, 21–29. https://doi.org/10.1016/j.drugpo.2018.12.004

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