Short and Long-Term Effects of Opioids

The opioid epidemic is something that affects every part of a person’s life whether it be the user or the user’s family. It also affects professionals that come into contact with the user. The opioid epidemic affects healthcare professionals because their patients are misusing the opioids that have been prescribed to them. Also, healthcare professionals are one of the first people to see a person once they have arrived at a healthcare facility. Opioids also affect the user’s family members such as children and their parents. Generally, the grandparents are left to raise their grandchildren once a person has become addicted to opioids. This situation can be very difficult for both the children and their grandparents. Lastly, the criminal justice system and law enforcement officers are affected by the opioid epidemic. The criminal justice system is affected by the opioid epidemic because some users cycle through the system on more than one occasion because they returned to the opioids once they were released. Law enforcement officers are affected by the opioid epidemic because they are the ones who respond to the initial call for help not knowing what they are going to encounter once they arrive on the scene. ?

The Effect of Opioids

The abuse of opioids has become increasingly problematic in modern society. This epidemic not only affects the addict, but it affects healthcare providers as well. I believe part of the opioid epidemic is due to patients relying too heavily on the pain killers; however, there comes a point at which the physician has to take a stand and stop prescribing pain killers for the patient. A physician should be treating the pain associated with the patient’s diagnosis; however, the physician should not continue to prescribe medications because the patient is asking for them. The addict could pose a danger to the healthcare professionals as well as other patients when they come into the clinic under the influence of the opioids.

Healthcare professionals can assist in ending the opioid epidemic by learning about their patients and writing prescriptions cautiously. Perhaps, the physician could prescribe an alternative drug that is not so addictive. The opioid epidemic needs to be controlled, but it has to start with our physicians and the practices that they exercise when writing prescriptions.

The opioid epidemic that we are experiencing affects so many lives beyond the user. The entire family of the user either sees or feels the effects of the addiction. The addiction to opioids has such a stronghold on the user that they are crippled in many areas of their life. The relationships that the user has with others suffer as a result of the addiction. This often leaves children without their parents and forces the grandparents to step in and assume that role. Grandparents are generally older and have health issues of their own and assuming the responsibility of raising grandchildren can take a toll on their health which could already be declining due to their age.

Some children are faced with the reality of going into foster care as a result of their parents’ addiction to opioids. The concept of foster care is great, but it still takes a toll on the children both physically and emotionally. This time can be difficult for the children because they are often too young to understand what is happening and why they are being taken away from everything that they know.

The opioid epidemic also affects the criminal justice system and law enforcement officers. Often, law enforcement officers are the first to arrive on the scene which means they are the first ones to see the patient. The law enforcement officers never know what they are going to find when responding to a call, so they have to be prepared for anything. Even though law enforcement officers have had training and know how to treat an overdose victim, it can still be tough for the officer to find the victim unresponsive.

Those that are addicted to opioids are probably familiar with the criminal justice system and may have been through the system more than once. The addicts cycling through the criminal justice system multiple times is costly and takes time away from other cases that need to be heard. There are several costs associated with a criminal proceeding such as court costs, attorney’s fees, and the cost of the opioid treatment program if ordered. The costs for these things can add up very quickly. If the criminal is not ordered to go through a treatment program, they are likely to continue this vicious cycle because they did not receive any treatment and just return to using the opioids. The purpose of this paper is to identify what the opioid epidemic is and its catastrophic effect. The epidemic will be seen from the healthcare perspective, the social science perspective, and the criminal justice and law enforcement perspective.

Opioid use in North America has dramatically increased over the past decade (Falk, Dahl, Raymond, Chateau, Katz, Leong, & Bugden, 2017). The opioid epidemic with which we are currently plagued affects several aspects of the addict’s life. The choices also affect those involved in the addicts’ life such as children, parents, and grandparents. The opioid epidemic affects healthcare and healthcare professionals. Healthcare professionals across the nation have significantly been affected by the opioid epidemic (Perez, 2018). The opioid epidemic has affected healthcare professionals in a couple of different ways. Some healthcare professionals are affected because the addicts are misusing opioids which usually results in the patient requiring medical attention. The healthcare professionals generally come into contact with the addict once the patient has arrived at the hospital. For some healthcare professionals, seeing patients in this state can be challenging. This is especially true if they are acquainted with the patient. While some patients recover from an overdose, this is not always the case. In 2016, 64,000 Americans died due to drug overdoses (Perez, 2018). This is a staggering number of deaths, particularly for something that could have possibly been prevented by educating the patients when they were prescribed the opioids.

Opioids are prescription medications that are generally used to treat pain; however, opioids are highly addictive. One of the most common opioids that are prescribed is Hydrocodone. Opioids can only be obtained with a prescription written by a physician. According to the U.S. Department of Health and Human Services (HHS), the number of prescribed and dispensed opioids doubled between 1999 and 2010 (McGaffigna, 2017). In 2013, there were approximately 207 million opioid prescriptions written (Harries, Lust, Christenson, Redden, & Grant, 2018). This is an alarming number of prescribed and dispensed opioids considering the drugs are highly addictive and that people have become dependent on opioids. 20% of patients receiving ambulatory care are receiving a prescription for opioid-based medication (McGaffigna, 2017). Opioids are a drug that the physician has to be extremely cautious with because of how easily the patient can become addicted to them. The patient has to use the prescription cautiously so that they do not form an addiction to the opioids. It is vital that you take the prescription exactly as ordered and only take the opioids when it is absolutely necessary. Some patients take the opioids long after the pain has subsided. It is at this point that problems begin.

Opioids are prescription medications that are generally prescribed following a medical procedure such as a surgery or a severe injury. Everyone has suffered pain at some point and wanted some medication to relieve the pain; however, pain killers such as opioids are highly addictive especially if taken too long. As a patient, one is programmed to turn to our physician to prescribe a medication that will help relieve the pain. Physicians are responsible for prescribing opioids to their patients, but they should only prescribe opioids to their patients if the patient truly requires the medication. The physician should monitor how long the patient has been prescribed the medication and only prescribe the opioids as a short-term solution so that the patient does not form an addiction.

A primary care physician limiting the number of opioids that they alone prescribe will not end the opioid epidemic, but it will help slow the epidemic down (Kotalik, 2012). If the patient’s primary care physician will not prescribe opioids for an addict’s pain, then they will find another physician that will write them a prescription for the opioids. An example of this would be a patient going to a walk-in clinic or an emergency room. These physicians generally do not have access to all of the patient’s medical records and have no way of knowing what medication the patient was prescribed previously unless the patient tells them. The problem is the addict will withhold certain information so that the new physician will prescribe them the opioids that they are requesting. Perhaps a solution to the opioid epidemic would be if all physicians had access to a database where they could easily see what opioids patients have been prescribed and the quantity. This would allow all physicians to monitor opioids and help crackdown on opioid abuse.

Another perspective that is affected by the opioid epidemic is the social services perspective which includes the family and extended family of the user. The user’s children suffer more than anyone else in the family unit as a result of the parent’s choice to use and become addicted to opioids. At this point, the user is not able to adequately provide care for their children and the children are either placed in foster care, or they go live with another family member. If the child is placed with other family members, this can place undue strain on those family member’s because the placement is usually for an extended amount of time. The most common family member for the children to live with are the grandparents. This can be challenging for both the child as well as the grandparents who are of the aged population. Grandparents raising their grandchildren can be tough as the grandparents are already dealing with health issues of their own and are now trying to raise their grandchildren full-time (Pinson-Millburn, 1996).

Children who are born to women who have used opioids during their pregnancy are likely to have developmental disabilities which could affect the child for several years to come. Children who are born to opioid users are at risk of having developmental disabilities such as inattention, hyperactivity, and the lack of social skills (Ornoy, 2001). Also, the environment in which the children are raised seems to be one of the most important factors that determine their developmental outcome (Ornoy, 2001). Thus, children born into an environment where drugs are prevalent are more likely to be behind developmentally. It is in these environments that children are often left to themselves and have little to no interaction which is necessary for their development.

Developmentally delayed children are at a greater risk of being made fun of when they begin school because they are “slow and not normal.” Children do not have the ability to look at another child and discern what their home environment is or understand why the child behaves in the manner that they do. Children that are born into this environment are at risk of being emotionally delayed as well. The child is either being raised by a parent who is not in a state where they are capable of raising the child, or they are being raised by a grandparent or foster parent. In either of these situations, the child is likely to be emotionally delayed because they are not capable of comprehending the situation and why they cannot be with their parents. This takes a toll on children and often results in the child either going through a time of depression and loneliness or the child will act out.

When a parent makes the decision to use opioids, they no longer have the ability to provide proper care for their children which sometimes results in the children being placed in foster care. The number of children being removed from homes with parents who are addicted to opioids has reached an all-time high. In Michigan, there were 6,000 occasions between 2015 and 2017 where children were removed from their families as a result of the parents misusing opioids (Serres, 2018). This is an alarming number of children being removed from their homes. Not only are infants being removed from the home because they were born to opioid-addicted parents, but older children are being removed as well because their parents have formed an addiction. Some of the children that are placed in the foster care system thrive, while others struggle with the changes that are associated with going into foster care. However, it is not always the children that struggle with the change. Sometimes the child isn’t a good fit for the family that they were placed with and the foster family struggles to make the placement work or adjust to having another child in their care.

Grandparents can be affected by the user’s addiction to opioids as well as the children. An alternative to children being placed in the foster care system is to go live with other family members such as aunts and uncles or grandparents. If the children have to be uprooted from the environment that they are familiar with, being placed with family is usually a better placement for the children because they will still be around family members that they are already familiar with. While the children that are placed with their grandparents are well taken care of, the children may have a difficult time adjusting to living with their grandparents and adjusting to their way of living because it is a lifestyle that they are not accustomed to. The new placement of the grandchild can also be difficult for the grandparents as they are juggling work responsibilities, a smaller income, and a home environment that is not geared toward children (Pinson-Millburn, 1996). The smaller income and a home environment that is not geared toward children can also be a challenge for the children to acclimate to.

The third aspect that is affected by opioid users is the criminal justice system and law enforcement officers. It is almost impossible for someone that has an addiction to opioids to not be involved with the criminal justice system at least once. Generally, opioid users have cycled through the criminal justice system on more than one occasion. Some opioid addicts cycle through the criminal justice system once, get released with minimal punishment and go right back to their prior behaviors. Their choice to continue that behavior leads them through the same cycle multiple times until the criminal justice system takes action and imposes a punishment that will get the user’s attention. However, there are a few opioid addicts that cycle through the criminal justice system, achieve sobriety, and transition back into society as a normal working adult. Obviously, for the sake of the children that are involved, this is the happy ending that everyone wants to see. Unfortunately, this has become the exception, not the norm.

Many opioid addicts go through the criminal justice system daily. One part of the criminal justice system that is affected by opioid users is criminal accountability. It is the responsibility of the criminal justice system to ensure that the opioid users are held responsible for the crimes that they committed (Degenhardt, 2013). 60-80% of the current and former prisoners were incarcerated due to drug-related charges (Chavez, 2012). With this many people abusing drugs, there is a great need to offer a drug abuse treatment program during their incarceration.

Opioid addicts are likely to continue cycling through the criminal justice system, or worse overdose, if they never receive proper treatment or go through a drug abuse program. Overdose is one of the leading causes of deaths among those released from correctional facilities (Brinkley-Rubinstein et al., 2018). The opioid addicts need to have access to a drug abuse program that they can go through while they are serving their time behind bars. The addicts reach sobriety while they are incarcerated because they do not have access to the opioids, but as soon as they are released and have access to the opioids again, they are likely to go right back to their previous lifestyle. This is especially true if they did not receive treatment during their incarceration. The opioid addict is 129 times more likely to overdose within the first two weeks of being released from incarceration and back into the community (Giftos & Tesema, 2018).

Inmates can be prescribed an opioid agonist therapy which has shown to reduce the number of opioid overdoses; however, fewer than 40 of the 5,000 correctional institutions in the country offer this treatment (Giftos & Tesema, 2018). While most institutions do not offer this treatment, there is a treatment that can be offered in an effort to prevent a relapse. Extended-release naltrexone is a monthly injection, which was approved by the Food and Drug Administration in 2010 and is used to prevent a relapse to opioid dependency (Lee, Friedman, Kinlock, Nunes, & Boney; et al., 2016).

A person’s choice to misuse opioids not only affects the individual, but it also has an emotional effect on law enforcement officers. Nobody wants to go to work knowing that they will likely encounter a person that is under the influence of opioids during their shift. The law enforcement officer never knows exactly what they are going to encounter when they receive a call (Green et al., 2013). This alone can be an emotional situation for law enforcement officers, but it can be even more emotional for them if they have to remove children from the home as a result of parents being addicted to opioids. Even though law enforcement officers are trained in first aid and have a knowledge of how to handle overdose victims, it still takes an emotional toll on the officers (Green et al., 2013). When law enforcement officers arrive on the scene of an overdose victim, they have been trained on the proper procedures of how to administer Naloxone and reverse the effects of the overdose (Purviance, Ray, Tracy, & Southard, 2017).

The opioid epidemic that we are faced with today, as a nation, is a true tragedy. Everyone is affected by the opioid epidemic in one way or another whether you know the addict personally or not. Healthcare personnel is affected by the epidemic because some of the patients that they have prescribed the opioids to are abusing the medications. Opioids also affect the addict’s children because their parents are no longer capable of caring for the children. Often, the children are removed from the home and either placed with other family members or placed in the foster care system. Either of these placements are difficult on the children because they are not accustomed to the environment in which they were placed. The opioid epidemic has an effect on the criminal justice system and law enforcement officers as well. The law enforcement officer is usually the first person to find a victim when they have overdosed. This can be a difficult situation for law enforcement officers to respond to. We must find a solution to the opioid epidemic before it is too late.  

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