According to the CDC, 91 people die everyday from opioid overdose. Deaths have increased since 2010. The root cause is debatable, yet since 1999, 400% in opioid prescriptions have increased.
In 1995, the Purdue Pharmaceutical Company released the drug, OxyContin. It’s an extended release oxycodone formulation branded for treatment of chronic non-cancerous pain. From 1996-2002, Purdue contributed to a large campaign to encourage chronic use of opioid prescriptions for pain. Not only that, but they asked doctors and nurses to include pain as another vital sign. Purdue financially supported the American Pain Society and other groups. They supported the message that long-term opioid use for pain was safe. In patient’s best interests, OxyContin became the best selling painkiller prescribed in the country.
Opioids are known for their analgesic ( pain ), sedative, and euphoric effects. They were originally derived from the poppy flower. Natural and synthetic opioids have since been formulated. Natural occurring opioids are Morphine and Codeine. Semi-synthetic opioids are Oxycodone, Hydrocodone, Heroin, and Hydromorphine. Synthetic opioids are Fentanyl, Methadone, and Tapentadyl. The CDC names Oxycodone, OxyContin, and Hydrocodone as the top prescription opioids implicated in overdosed deaths.
Since 2007, IV Heroin usage increased over other drugs of abuse. The DEA reported 200% increase of Heroin overdosed deaths from 2000-2014. Since 2013, overdoses involving Fentanyl has affected the opioid crisis in North America. Fentanyl is used as an anesthetic as well as an analgesic in the medical field. It is the most potent opioid narcotic available. It is 50-100 times more potent than Morphine. The problem is the non-pharmaceutical Fentanyl is being manufactured illegally overseas, primarily China, and trafficked to the US, Mexico, and Canada. This powder is mixed with heroin and made into pills that looks identical to the common prescribed opioid medications. The high potency is equivalent to a few grains of salt. The short term effects are respiratory depression and decreased levels of responsiveness that leads to overdosed deaths.
When using opioids, the reward center in the brain is stimulated. Once individual moves beyond the early stages of pleasure and reward seeking, a more complicated neuro-biological process takes over. The more exposed to the drug, the more the drug is needed to achieve the same affect. Once individual acquires escalating doses of opioids to achieve pleasure and analgesic affects, the person has developed a tolerance. Tolerance results when the receptors in the brain cells become less responsive to opioid stimulation. Opioid dependence occurs when the body has adapted to presence of drugs and will suffer physical symptoms in drug’s absence. They will suffer withdrawal symptoms if drug stopped suddenly. The withdrawal symptoms include anxiety, jitteriness, dilation of pupils, muscle cramps, insomnia, GI upset, and Tachycardia.
It is important in this opioid epidemic to decrease the access and exposure to the opioid drugs.