The Opioid Crisis

Opioids are highly addictive drugs that were primarily enlisted to help reduce pain for patients in medical situations, but the effects on the body have been studied and they cause much more harm than there are benefits. Their euphoric properties have led to its use for recreational purposes, meanwhile their addictive properties have led to the chaos of the opioid epidemic. Many receive these drugs through discreet dealing or through intentional injuries, just to receive these drugs. These drugs have become highly used and they are causing harm to many. The varieties and their addictiveness have made opioids a major issue, and leading to many people suffering. A majority of opioids cost less than $5, but these opioids have caused $35 billion in health care costs. 

Opioids primarily came from the opium poppy plant (Papaver Somniferum). After its original creation, they were then created synthetically, and currently the combination of the processes are used. Examples of opioids include: opium, morphine, and fentanyl. Chemically, opioids increase the dopamine in the brain, and that increase results in pleasure. That pleasure makes the person want to repeat it, and becomes an addiction. When used long enough, the opioid can become a respiratory depressant, it can cause obstructions and perforations in the digestive system, and it can result in hyperalgesia in the liver. Hyperalgesia is “an increased sensitivity to feeling pain and an extreme response to pain. Hyperalgesia may occur when there is damage to the nerves or chemical changes to the nerve pathways involved in sensing pain”. 

In the discussion of opioids, many have considered the similarities and differences in addiction and drug dependency. Drug dependence is designated by having a physical dependance on a substance, and the person having tolerance and withdrawal. Although addiction can be similar, it is also different in the way that addiction is a chronic relapse that creates a physical and psychological dependance on drugs. When addicted, the person knows that they have to stop, but their need dictates their actions. This creates a way for themselves or others to be put in harm’s way. This overall change in behavior dictates the distinction between dependency and addiction. 

Currently, there are three million people in the United States that have an opioid use disorder, otherwise known as opioid addiction. For many of these people, if they choose to seek help, they would be directed to go to therapy or have medications. Therapies can include inpatient/residential care where the patient lives at the treatment center. This tends to be the most intense form of treatment, but it is highly regulated and monitored. Another form of therapy includes outpatient treatment. This service lets the affected person live at home while they still receive treatment at a center. At these inpatient and outpatient facilities, detoxification is possible, and it allows for drugs to leave the affected person’s body completely. Along with this, individual and group therapy tries to help the affected person with why they’re addicted and it gives them some ways to avoid relapsing in the future. Therapy is a major resource, but it can be used in tandem with medication. This includes methadone and buprenorphine (suboxone), which activate the receptors in the brain to relieve cravings. Another medication is naltrexone, and that suppresses the euphoric/sedative effects not affecting the opioid receptors. These medications and therapies are very good for the long term effect of opioids, but in major situations, a medication named naloxone is used to clear the receptors in the brain to prevent overdose effects on the body . 

To prevent this crisis for the future, the best decision would be to get rid of opioids entirely, but that just wouldn't be possible. Not only do many patients need this medication to alleviate their pain , like cancer patients, mothers who had a c-section, patients of major surgeries, etc., but there would be a massive growth of underground selling and even more deaths because of the lack of discussion due to the heightened stigma. This would only lead to more deaths and the growth of the use of this drug. 

To combat this issue, I recommend including more discussion on the use of naloxone, an opioid antagonist, especially its usage and how to use it, and it should be more widely available. “A large-scale national study showed that opioid overdose deaths decreased by 14 percent in states after they enacted naloxone access laws”. The ability to know how it is used, when to use it, and having accessibility to it can allow many to be saved from the massive death toll. What can also be done is to limit the usage of opioids by prescribing other non-addictive painkillers including: acetaminophen, NSAIDs, gabapentin/pregabalin, tricyclic antidepressants and serotonin/norepinephrine reuptake inhibitors, and topical agents. These painkillers can relieve the pain a person is having without the addictive side effects of using opioids. Along with this, if there is a necessity for prescribing opioids, then the use of extended release opioids can be used. It is stated that, “a lower maximum daily dose has been associated with a reduced risk of respiratory depression and overdose”.

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Erica Manandhar is a sixteen year old student in the United States. She has a great passion for medical and scientific knowledge and wishes to only learn more. In her free time, you can most likely find her scrolling through TikTok, finding outfit inspiration on pinterest, reading fiction novels, or spending time with friends.

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