Combating the opioid crisis

This alarming epidemic requires everyone’s help to counteract

The opioid crisis has been national news for the past several years, affecting thousands of people throughout the country, with seemingly no end in sight. It involves an increase in opioid addiction and overdose caused by misuse of opioids, such as prescription pain relievers, heroin, and synthetic opioids like fentanyl. 

Opioids trigger the release of endorphins, the “feel good” neurotransmitter, which numb your perception of pain and boost feelings of pleasure. When the drug wears off, you can have a desire to experience those good feelings again. Continuous use of this drug can lead to dependency and, eventually, addiction.

While the epidemic has peaked within the past five years, it has been gaining momentum since the late 1990s. This was a time when prominent pharmaceutical companies reassured members of the medical community that patients wouldn’t become addicted to prescription opioid pain relievers, resulting in widespread misuse of these medications by physicians before it became clear they were highly addictive. 

The statistics showing the prominence of opioid misuse and overdose warrant immediate attention from consumers and legislators. According to the Centers for Disease Control and Prevention (CDC), more than 130 people in the U.S. die every day after overdosing on opioids.

From 1999-2017, more than 700,000 people died from drug overdoses. That is more than 10 times the number of people who died in the Vietnam War.

Opioids are often prescribed for chronic pain; however, roughly 25 percent of patients prescribed opioids for chronic pain misuse them. Approximately five percent of people who abuse prescription opioids will transition to heroin.

The most common states of the country experiencing this opioid crisis are in the Midwest—including Ohio, Wisconsin, and Minnesota.

The CDC says the economic burden of this crisis is $78.5 billion a year, including costs of healthcare, loss in productivity, addiction treatment, and criminal justice involvement.

The significant magnitude of this national crisis is quite apparent. Here, we will identify and examine current approaches to correct the opioid crisis and what you can do in your community to combat the opioid crisis.

What government is doing

With all of these startling statistics, what is being done about it? Several government agencies are brainstorming new ideas and programs to counteract this growing crisis. For instance, the U.S. Department of Health and Human Services (HHS) has several approaches including:

• Developing treatment programs that optimize the use of opioid treatment medications such as Buprenorphine, Naltrexone, Clonidine and Methadone.
• Continuing to research the use of cannabis as a new tool in the treatment of opioid addiction. Cannabis and opioid systems in humans interact very closely. Perhaps this will open a door for the development and utilization of cannabis-related medicines to treat opiate addiction. Although promising, much more research needs to be done. Cannabis will not be the solution, but it may be a significant component in the war against the Opioid Crisis.
• Improving access to treatment and recovery services.
• Promoting the use and widespread availability of overdose-reversing drugs such as naltrexone (Narcan).
• Strengthening understanding of the epidemic through more public health surveillance data.
• Providing up-to-date research on pain and addiction.
• Advancing better practices for pain management by healthcare professionals.

The National Institute of Health (NIH), a research branch of HHS, echoes these initiatives by conducting research for new non-addictive strategies to manage chronic pain, as well as meeting with pharmaceutical companies and healthcare professionals to prevent the snowball effect of opioid misuse.

The CDC plans to take it one step further by partnering with public safety, such as law enforcement, to address the growing illicit opioid problem. Officials are also considering attacking the source to reduce opioid availability. This includes targeting the opioid manufacturers who produce much more medication than is actually needed.

Purdue Pharma, the manufacturer of Oxycontin, is currently involved with lawsuits from over 30 different state attorneys general (including Minnesota’s) and over 1,500 personal liability suits. We are just at the beginning of these legal challenges.

Also, legal minds have discussed the possibility of prosecuting the large pharmaceutical distribution companies that make sure that the supply is plentiful across the country by delivering opioids to every drug store in the country at quantities that appear to be ridiculously high.

What local communities must do

An important question to ask is what you can do at a community level. You must realize that anyone who takes opioids is at risk of developing an addiction. The public must be made aware of this. An individual’s personal history and the length of time opioids are used both play a role, but it is impossible to predict who’s vulnerable to eventual dependence and abuse of these drugs.

Another thing you can do for your family and community is become aware of the signs of addiction, which include but not limited to:

• Irresistible craving for a drug
• Compulsive use of the drug
• Continued use of the drug despite repeated harmful consequences

If you are prescribed an opioid by your physician to manage acute pain, such as after a surgery, opioids are safest when used for three or fewer days. Try to avoid using opioids unless you absolutely have to for recurrent chronic pain.

If you do need opioids, ask your doctor for the lowest possible dose for the shortest time required, and use it exactly as prescribed. The key is to have a discussion with your doctor on the proper pain management specific for you.

You can help prevent addiction in your family and community by disposing of unused opioids properly, specifically by contacting local law enforcement or using the Drug Enforcement Administration (DEA) medication discarding and take-back programs. If there are none in your area, contact your pharmacist on how to properly discard the medication.

It is critical to realize that anybody who uses opioids, either prescribed or illegal, are at risk of developing dependence and possible addiction. Therefore, we must educate ourselves and our community of this matter to combat this evolving crisis one neighborhood at a time.

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He received his M.D. and Master’s Degree in Molecular Biology and Genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Dr. Crutchfield was recognized by Minnesota Medicine as one of the 100 Most Influential Healthcare Leaders in Minnesota. He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations, and president of the Minnesota Association of Black Physicians.

 Alexis E. Carrington is a senior medical student at St. George’s University School of Medicine and a graduate of Pepperdine University. She is currently applying for a dermatology residency and research fellowship.