Painkiller Addiction: On the Rise or Under Control?
The threat is real. The Drug Enforcement Administration (DEA) recently released the 2015 National Drug Threat Assessment (NDTA), which found that death due to overdose is the largest injury death cause in the United States today. With a number that is higher than the deaths caused by firearms or the deaths caused by car accidents, it is estimated that more than 46,000 people in the US died of a drug overdose in 2013 and that more than half of those were due to opiate drugs, including heroin and prescription painkillers.
But those numbers are from 2013, and since that time, measures have been implemented in different parts of the country to help to fight the problem. So are these preventative measures working to get the problem of opiate addiction under control now at the end of 2015, or is the issue of opiate addiction still on the rise?
More than 10,000 overdose deaths were avoided between 1996 and 2010 due to the use of naloxone, an opioid antagonist that blocks the effects of opiate drugs, according to the Centers for Disease Control (CDC). With the implementation of laws that increase access to naloxone for law enforcement who may be first responders on an overdose scene, and concerned friends and family members of people living with addiction, that number has most likely increased significantly over the past five years.
It is estimated that the opiate overdose death rate may be cut in half by wider use of this drug alone. Many states have responded by making the drug available by prescription to those who would like to have it on hand in the event of an overdose and also by distributing the drug to police officers and other first responders.
As more and more states implement Good Samaritan laws that protect those who stay with an opiate overdose victim until help arrives from legal prosecution and improve access to naloxone, it is likely that opiate overdose rates will decrease.
Changing Painkiller Prescription Practices
Since 2010, many changes have been made in the medical community with the goal of increasing the understanding of dangers related to the use of prescription opiates like OxyContin and Percocet. Improved education of family physicians who do not specialize in pain management as well as the requirement to educate patients on the nature of the drugs have been part of those changes in some parts of the country.
Additionally, many states have implemented a statewide prescription drug database that allows pharmacists and prescribing physicians to input data regarding opiate painkillers prescribed to patients to track prescriptions and identify prescription drug abuse and addiction.
The Obama administration is trying to take this a step further by working to increase the level of training for federal doctors and requiring that all federal health insurance plans cover the costs of treatment for addiction.
Some also believe that the treatment of opiate addiction should be improved as well. For example, some organizations, including the American Society of Addiction Medicine, say that the medications available for treatment of opiate addiction (e.g., buprenorphine, methadone) are significantly underutilized. Thus, increasing the use of these drugs, especially in programs like Medicaid and Medicare where they are frequently underused, may help to improve the outcome of people in opiate addiction treatment.
The Link between Opiate Medications and Heroin
It may be that prescription painkiller overdose death rates will be positively impacted by changes to prescription regulations and increased education among prescribing physicians and patients. Naloxone, too, should have a positive impact on the rates of overdose death caused by use of opiate painkillers, especially if naloxone is prescribed along with every prescription for an opiate drug as some suggest.
Many believe that increased rates of heroin abuse, addiction, and overdose are directly related to the high numbers of prescriptions handed out for painkillers in the first decade of this century. Rather than seek treatment when legislative changes made it more difficult to get pain pills to feed an addiction, many who were addicted to pain medication turned instead to the cheaper and more readily accessible high provided by heroin use. Rates of heroin use increased by 51 percent between 2013 and 2014, according to a SAMHSA survey, and the amount of heroin seized in the United States has almost doubled since 2010.
Stemming the rate of new cases of painkiller addiction may help to thwart the increase in rates of heroin use eventually, but right now, heroin may be the rising epidemic. Painkiller addiction may be coming under control and slowly hitting a downward trend thanks to the efforts of the community at large, concerned friends and family members, support from nonprofit agencies, changes in practice in the medical community, and positive legislative changes.
Hope through Abstinence
The best way to completely avoid opiate overdose, and addiction that could lead to overdose, is to stop use of all substances of abuse. Help is necessary, as opiate addiction always requires medical detox. People who are living with an active addiction or even a physical dependence without cravings are encouraged to seek professional detox and addiction treatment in order to make the transition into sobriety safely and effectively. If someone you care about is living with a dependence upon painkillers or heroin – or even if that person only occasionally abuses opiate substances – don’t wait to take action.