Misuse of opioids has become a definite crisis in the U.S.
According to the SAMHSA (2017), overdosing of opioids resulted in 42,249 deaths in 2017. To better understand the magnitude of this data, opioids overdose mortality exceeds breast cancer. Meanwhile, the SAMHSA (2017) also approximates that 11.4 million people have misused prescription opioids and 2.1 million have an opioid use disorder. The obvious fix to this problem to this mess would be to halt the supply of the drugs. However, here goes the dilemma. Opioids are viewed as the most effective and reliable analgesics agents.
They have been used for years to treat severe or chronic pain caused by trauma or terminal ailments such as cancer (Volkow, Benveniste, & McLellan, 2018).
Argumentative essay Thesis Statement: Even though a number of individuals oppose limiting the medical use of opioids in the US, the opioid crisis can be fixed through two main approaches: changing the current perception between the connection between opioids and pain; and setting limits on prescription of opioids.
The current opinion is that opioids play an important role in the elimination of pain and should not, therefore, be denied to those who need it. It is seen as the most effective when it comes to relieving pain such as back pain, central pain syndromes, and chronic pain from disease such as cancer. It also relieves the severe pain that is caused by trauma, extensive burns or surgery. This notion is stimulated by how the drug deals with pain. When opioids enter the body, they attach to the opioid receptors and inhibit pain, minimize anxiety, and generate mild sedation to the user.
These effects are definitely good news to pain patients who would have had to agonize with the excruciating pain. While there is minimal debate whether opioids should be used for severe and cancerous pain, there are different opinions when it comes to use for acute pain. Medical professionals who endorse its use for continuous non-malignant pain insist that it is unethical to deny patients under excessive pain a solution to their problem. However, this approach facilitates opioid misuse and overdose.
Americans must change their current perception on pain and the role of opioids. First, opioids are not the most effective in treating long-term pain problems such as fibromyalgia, pelvic pain syndromes, and backpain. A systematic review study conducted by Chou et al (2015) has indicated that there is insufficient evidence that prolonged opioid prescriptions are effective in dealing with chronic pain.
Instead, they determined that as patients continue to use the drug, they become more dependent on it and develop withdrawal problems (Chou et al., 2015).
The pleasurable feelings that these drugs produce increase their probability for abuse. The ability of the drug to activate the internal reward system makes the drug addictive and exposes addicts to other health problems such degeneration of automatic functions (Volkow, Benveniste, & McLellan, 2018). With these facts in mind, it is important for physicians and patients to consider alternative techniques of abating pain such as physical therapy, and non-opioid drugs. Medical practitioners should not often help pain patients to regain their body functions even when under pain without relying on the drug.
Washington, Massachusetts, Nevada, Florida, Rhode Island and Arizona are among twenty six states that have set statutory limits on prescription of opioids. These states have set different limits ranging from three days to fourteen days, with other having daily morphine milligram equivalent (MME) limits.
These restrictions are largely driven by the limits set by the federal agency, Centers for Disease Control and Prevention (CDC) (Davis et al., 2018).
However, these restrictions have attracted criticism from patients as well as physicians. In Washington, where the daily restriction was set at 90mg, medical professionals and patients heavily oppose the move claiming that it is an extremely aggressive move the government to control opioid misuse. Doctors assert that these regulations impose fear on them to extent that they are unable to prescribe any opioid so that they can do not break the law.
Additionally, patients and academics argue that statutory limitations will push opioid users to who are already dependent on the drug to seek illicit ways of obtaining it (Parker, Strunk, & Fiellin, 2018).
This means that as more states introduce statutory limits, the country is likely to record more deaths caused by heroin and drugs with similar effects. Furthermore, critics note that such restrictive laws and regulations are targeting the wrong citizens: the government should focus on illicit users and those who supply the drugs to these individuals. However, these arguments are largely insubstantial if one looks at the purpose and research backing the laws.
The purpose of the restrictions on the opioid prescriptions is meant to ensure safe and responsible usage of opioids.
These laws target opioid-naïve patients and those who seek to use opioid for acute pain (Davis et al., 2018).
This law is based on evidence that patients who seek initial prescriptions for acute pain could quickly shift to chronic users as their bodies become tolerate and dependent on the medication (Shah, Hayes, & Martin, 2017). Besides, increased prescription refills and the period of subscription are also linked to making patients to become dependent on opioids. In response, studies recommend having checks on the quantity of initial opioid prescriptions (Jeffery et al., 2018; Shah, Hayes, & Martin, 2017; Davis et al., 2018). Additionally, these laws are sensitive to the needs of those who are under chronic and severe pain. It exempts oncology patients, palliative care patients, and other terminally ill patients from the prescription and advice doctors to use best practices when dealing with such patients.
Fixing the opioid crisis will require stakeholders to implement policies that may appear undesirable and unpopular. Patients and physicians, especially where the pain is acute, should not consider opioid drugs as a first option. Instead, they should seek alternatives methods of dealing with the pain such as physical therapy and non-opioid medications. Also, policymakers need to set limits on the opioid prescriptions when the purpose of medication is meant to relieve acute pain. These approaches will help reduce the use and circulation of opioids, and thereby minimize misuse and abuse of opioids.
Chou, R., Turner, J. A., Devine, E. B., Hansen, R. N., Sullivan, S. D., Blazina, I., & Deyo, R. A. (2015). The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Annals of internal medicine, 162(4), 276-286.
Davis, C. S., Lieberman, A. J., Hernandez-Delgado, H., & Suba, C. (2018). Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: A National Systematic Legal Review. Drug and Alcohol Dependence. https://doi.org/10.1016/j.drugalcdep.2018.09.022
Jeffery, M. M., Hooten, W. M., Hess, E. P., Meara, E. R., Ross, J. S., Henk, H. J., ... & Bellolio, M. F. (2018). Opioid prescribing for opioid-naive patients in emergency departments and other settings: characteristics of prescriptions and association with long-term use. Annals of emergency medicine, 71(3), 326-336.
Parker, A. M., Strunk, D., & Fiellin, D. A. (2018). State responses to the opioid crisis. The Journal of Law, Medicine & Ethics, 46(2), 367-381.
Shah, A., Hayes, C. J., & Martin, B. C. (2017). Characteristics of initial prescription episodes and likelihood of long-term opioid use-United States, 2006-2015. MMWR. Morbidity and mortality weekly report, 66(10), 265-269.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2017). National Survey on Drug Use and Health, Mortality in the United States, 2016. Retrieved November 9, 2018, from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1- 2016/NSDUH-FFR1-2016.htm
Volkow, N., Benveniste, H., & McLellan, A. T. (2018). Use and misuse of opioids in chronic pain. Annual review of medicine, 69, 451-465.