The face of drug abuse is changing rapidly, and what many see as an inner-city problem is quickly moving into the suburbs, striking at the heart of America and changing the way doctors, politicians and ordinary citizens approach the issues of drug dependency and rehabilitation.
There are many factors underlying the shift in patterns of drug addiction, but the overuse and abuse of prescription pain medication are undoubtedly the most significant. The results of this reliance on prescription painkillers have had unintended consequences, the most serious of which is the current epidemic of accidental overdoses.
As of 2015, drug overdoses were responsible for more than 52,000 deaths in the United States alone, making overdose the leading cause of death for that year. Worse yet, the current opioid epidemic and the resulting overdose issues have shown no sign of slowing down. Instead, the epidemic continues to pick up steam. As pundits and politicians continue to argue over the solutions, the doctors, addiction counselors and first responders are working hard just to keep up with the scope of the problem.
According to the National Institute on Drug Abuse, pain relief was cited as the most significant reason for the misuse and abuse of opioid pain medications. That is a significant statistic since it points to a number of distinct but interrelated problems. On the one hand, the number of people who cited pain relief as a primary driver of the misuse of opioid pain medications suggests that pain is not being adequately treated. On the other hand, the rise in prescriptions for these powerful painkillers suggests that doctors are being too generous in their prescribing patterns.
So what is the answer, and how can the monster of prescription drug addiction finally be tamed? As with all things societal, there is no one answer to the opioid epidemic, and a lasting solution will have to address the needs of patients suffering from chronic pain, the medical community, those in addiction treatment, politicians on the left and right and the community at large.
There are a number of solutions that have already been proposed, and these ideas are currently being tested in communities around the country. This experimental approach to breaking the link between pain treatment and addiction is a step in the right direction, and this evidence-based approach to addiction has the best chance of success.
One intriguing idea is limiting the number of opioid pain medications prescribed upon discharge from the hospital. In many parts of the country, patients are sent home with a 30-day supply of powerful painkillers, even if the duration of their post-surgical pain is expected to be less than a week.
That mismatch between the duration of pain and the number of pain pills prescribed is an obvious problem, and it may contribute to another major issue – the unsupervised sharing of opioid pain medications. The sharing of opioid pain medications is a largely overlooked problem, but a number of recent studies have brought it to light.
As reported by the PBS Newshour, the sharing of pain medication with friends is a major driver in the current opioid epidemic and a contributor to the rise in overdose deaths. Taking these powerful pain medications without medical supervision, and often without sufficient reasons, is a recipe for disaster and a big part of the current crisis.
There are a number of ways to manage pain medication more efficiently and reduce the incidence of medication sharing and other misuses. Reducing the number of pain pills dispensed is an obvious solution and one that many doctors and hospitals have already embraced. Instead of sending their patients home with a 30-day supply of a powerful opioid painkiller, the prescribing physician may write a prescription for a 3 to 7-day supply instead.
That approach provides patients with the post-surgical pain relief they need without fueling the opioid crisis or risking the misuse of the medication. Patients who are still experiencing high levels of pain after the prescription ends can see their doctors for additional help on a case-by-case basis. This helps to personalize the approach to pain management, something that is sorely needed.
The hosting of prescription drug takeback days is another proactive approach to the opioid crisis. These take-back days are hosted by local communities, and they give patients the chance to dispose of unwanted and expired medications safely, without the risk that they will be redirected and possibly misused.
The effectiveness of these prescription drug takeback days is further bolstered by studies that show drug sharing is a major driver of the prescription drug crisis. By getting these powerful and potentially dangerous drugs out of homes and medicine cabinets, the sponsors of these drug takeback efforts are doing their part to fight the crisis.
No discussion of the crisis of prescription pain medication addition would be complete without a look at the underlying pain problem. From acute post-surgical pain to ongoing chronic pain caused by back problems, spinal misalignment and other issues. Pain is a very real issue and one that must be addressed head-on.
Many doctors are recognizing the insufficiency of prescription pain medication alone and the unwanted side effects the long-term use of these drugs can cause. Ironically, the long-term use of pain medication can actually increase sensitivity to pain, leading to a dangerous spiral of dependence and addiction.
That is why many physicians and pain specialists are now looking at alternatives to prescription opioids. From yoga and physical therapy to biofeedback and acupuncture, these pain relief measures can be used to reduce dependence on prescription medications, or even replace opioids altogether.
There is no easy solution to the current opioid epidemic, and a multifaceted approach is needed to address this serious problem. From limits on prescribers and electronic tracking of prescriptions to the more careful management of post-operative patients to alternatives to traditional pain medications, there are many things politicians, doctors and patients can do to address the opioid crisis and tackle the epidemic of dependence, addiction and overdose deaths.