Prescription rise of prescription opioid drug overdoses since 1990

Prescription
opioid painkillers are every so often given for the management of pain in the setting
of a therapeutic relationship involving medical professionals looking to
relieve pain in their patients. Prescription opioid painkillers include
oxycodone, hydrocodone, codeine, methadone and morphine.  In USA before 1995, prescription opioid pain
killers were being given mostly to people in pain from advanced cancer, extreme
injuries or after a life threatened or painful surgery, but now, most of these
drugs are given even with a light pain from injury or headache. In between 1999
and 2012, about 183,000 people died due to overdose of prescription opioids (“Curbing
dependency”, 2017). Prescription opioid overdose is currently the rapid growing
drug issues in US.  Since in 2003, a lot of
overdose death have been caused by opioids prescription more than heroin and
cocaine put together. Opioid overdose death happened a lot to men ages between
20 to 64, non-Hispanics whites, lower socio-economic status, poor and rural
communities (Paulozzi, 2012). Frighteningly, since 1990, US life expectancy for
the most disadvantaged has decrease by four years. The rise of prescription
opioid drug overdoses since 1990 excessively affecting non-Hispanic whites may
have play a part to this decrease (“Opioid use”, 2013). Prescription painkiller
overdoses affect families and communities all over the country (CDC, 2012).

Today,
in America about 40 percent of drug overdoses that result in death are from the
use of prescription opioids compare to any form of other form of death by
injury. (Hamburg, 2012).  According to
CDC, “whites and American Indians and Alaska Natives, as well as people who
have substance abuse or other mental health problems, have higher rates of
overdose compared to other groups” (CDC, 2012). In 2009, about half a million-emergency
department visit were because of many people overdosing or abusing prescription
opioids and every year it cost health insurers 72.5 billion from the non-medical
used of these drugs in healthcare cost (CDC, 2012).

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Furthermore,
It is important to understand the causes of increase in prescription of opioid and
how people in the U.S. arrived to this point. The increase in opioid
prescriptions is partially because of health care providers’ well-meant effort
to decrease patient long, non-cancer pain such as ailment, osteoarthritis and
other conditions. Medical professionals were trained to include    pain as a form of vital signs or to some
degree controlled or managed the pain no matter how light it is.  The additive form of prescription opioid when
it was initially brought into the health system, was not well known and understood.
This lead to a lot of patient to relying more on those drugs and doctors remain
to help them by writing them more opioid prescriptions which eventually leading
to some of them to overdose on them (Nemecek, 2017). Currently, because of how medical
knowledge have developed, doctors are very much aware on opioid and they know
that “Opioids shouldn’t be used to treat pain caused by many medical conditions
and injuries beyond the initial period of healing. A patient doesn’t need a
30-day prescription for a high-dose opioid following a tooth extraction or a minor
injury” (Nemecek, 2017).

As
medical practitioners when it comes to prescribing opioids and in fact any
other medications, they must ponder upon the risk and benefit of the
medication.  The most difficult task is
finding the ideal balance between the danger of over prescribing, which can
lead to overdose, addiction, and under prescribing which can cause
undertreatment of pain. One could think that reducing opioid prescribing to
people at greater risk may seem like a simple solution to the overdosing problem,
but that will probably end up causing an under-treatment of for patient in
severe pain while other patients will likely end up using heroin use or get prescription
opioids through other sources which could be illegally or dangerous (Rastegar,
2013).

Agencies
such as CDC, DEA and FDA, DAWN are working to fight opioid overdose. Food and
drug administration(FDA) is part of a bigger administration wide strategy to fight
opioid abuse. In 2012, FDA insisted on manufacturers of extended-release
opioids to create programs to inform prescribers about the drugs many dangers. FDA
made some transformation to intensify warning on the labels of extended-release
opioids and required manufacturers to preform extra studies. Drug Enforcement
Administration (DEA) also followed some FDA recommendations to limit
prescription of hydrocodone mixture products to decrease the misuse and
overdose of products such as Vicodin (Hamburg, 2014). According to the Hamburg,
FDA “continue to encourage the development of both non-opioid pain medications
and technologies that will make opioids less susceptible to abuse. FDA is also
supporting the development of better treatments for addiction” (Hamburg, 2014).
The Substance Abuse and Mental Health Services Administration’s Drug Abuse
Warning Network (DAWN) is a public health information system that follows and keep
track of the effect of drug use, mishandle, and exploitation in the United
States by checking and observing drug-related hospital ED visit (“Vital signs”,
2013).

Moreover,
The U.S. government, federal state and local are all working together to fight
the epidemic of the prescription opioid overdose. And most importantly they are
also following and keeping an eye on the trends of issue to better understand
the increasing epidemic.  The federal government
are putting forward educational material to health care providers and the
public to inform them about the increasing overdose issue of prescription drug
abuse. They are creating, evaluating and promoting programs and policies established
to stop and handle prescription drug abuse and overdose, at the same time making
sure that patient have better and safer access to pain treatment. States are
now using prescription drug monitoring programs (PDMPs), which are electronic
databases that keep a record of all prescriptions for painkiller in the states.
States can also now “pass, enforce, and evaluate pill mill, doctor shopping” to
decrease prescription analgesic abuse. They can push professional licensing
boards to take actions against inappropriate prescribing, add and improve access
to substance abuse treatment (CDC, 2012).

Another
strategic way of reducing the issue of drug overdose are putting in laws that
require physical examinations, before prescribing may perhaps help decrease the
diversion of these drugs for nonmedical use (Paulozzi et al , 2012).  Adding of secondary and tertiary prevention
measures to advance emergency and long-term treatment should be included in public
health approach to the issue of prescription drug overdose. This can include “overdose
harm reduction programs emphasize broader distribution (to nonmedical users) of
an opioid antidote, naloxone, that can be used in an emergency by anyone
witnessing an overdose” (Paulozzi et al, 2012). Society can also help to
decrease the rising epidemic. Individuals using prescription opioid as written
to use by our healthcare provider, not selling or sharing those drug to others.
Individuals must always store these kinds of drugs in secure and safer place and
dispose them in the appropriate way (CDC, 2013).

            This epidemic is shockingly increasing and causing a lot of
death. This can’t be solved or control by just one entity, but a big effort
from prescribers, pharmacists, scientists, public health officials, law
enforcement, patients and their families. (Hamburg, 2014). Stronger health and
social systems are necessity in the USA to help with the prescription opioid
epidemic (“Curbing prescription”, 2017).

With
the increasing number of prescription opioid overdose and some causing death. There
will be the need  of help from the whole
community to join  together to fight the
epidemic.