October 27th 2017: The day the US declared the opioid crisis a national emergency.

President Donald Trump declares the Opioid Epidemic a national emergency, a 5-point plan is put in place by the U.S. Department of Health and Human services (HHS) and warnings are issued to clinics, practices and hospitals across the country. It is crisis that is currently killing more people per day in the U.S. than people dying from car crashes and shootings combined.

What actually is the Opioid epidemic and why is it so important that it is tackled effectively?

The Opioid epidemic is defined as the ‘rapid increase in prescription and non-prescription addiction to opium based drugs. Opioid drugs include legal drugs such as morphine, diamorphine, fentanyl, oxycodone, codeine and also illegal drugs such as heroin.

Over the last few years the Opioid crisis has been covered extensively by news outlets across the world, and more so since it has been declared a national emergency. You’ve probably all heard about it, read about it or seen it being shared on social media platforms. Remember the shocking photo of the 4-year old boy sat in the back seat of a car whilst his parents overdosed on heroin? That photo went viral and for good reason.

It’s shocking, its gut wrenching and the fact that this epidemic has no boundaries and has been linked to people of all races, backgrounds and socioeconomic backgrounds makes it even scarier. This can affect anyone.

It is having a catastrophic effect on people in the U.S. and around the world, and the facts are hard to fathom.

  • More than 100 people per day die in the U.S. as a result of addictions either to prescription or non prescriptive opiods. This is more than the number of people who die in car accidents and shootings combined.
  • The life expectancy of adults in the U.S. has dropped for a second year running, and for the first time in more than half a century. This drop has been largely attributed to the overdoses occurring from opioid use
  • 2 million people in the U.S have become dependent on or abused prescription pain killers and illegal drugs.
  • More babies than ever are being born to mothers with opioid addictions.

How has the usage of opioid painkillers reached such unprecedented levels that its use and overuse resulted in it being declared a national emergency in the world’s biggest superpower? It has been implied that the overenthusiastic prescribing of strong painkillers in the U.S. from the mid 90s to mid 00’s are to blame. Drug companies marketing strong opioid based painkillers in this time period saw a huge increase in their prescribing use, and whilst the highly addictive properties of the drugs only became apparent after its use became widespread. What we are witnessing now is the surge of these addictions and the aftermath of these prescribing trends.

Prescription/non prescription addiction

Should we be distinguishing between the two? As a pharmacist I naturally feel uneasy about grouping these two addictions together. I’ve been accustomed to treating the addiction to non-prescription medication and addiction or ‘dependency’, (as it would be called) to prescription medication quite differently. Should we be seeing a more similar approach in the treatment of both these addictions? Studies show that up to 30% of people who are prescribed opioids misuse them, 80% of people who use Heroin first misused prescription medications. And how can we pick up these dependencies and addictions quicker? The Controlled drug requirements in the U.K. are strict and we are seeing more opioid or opioid similar medications being put in the Controlled drug category. Tramadol, being one of the more recent ones. Its highly addictive and dependent properties are now being abled to be more closely controlled and monitored.

Should we be reserving opioids only for palliative patient and picking up and challenging its use in chronic pain settings?

The U.K. is likely to see a similar crisis

The U.K has been issued a warning by Ambassador William Brownfield, Assistant Secretary of State for International Narcotics and Law Enforcement Affairs. ‘The U.S. crisis came on very suddenly and very unexpectedly and the same could easily happen in Britain’ it is imperative that the UK learn from the trends and mistakes that the U.S. has faced to prevent a similar outcome in the U.K.

In 2015, the annual European Drug Report recorded from the national office of statistics reported 330,445 high risk opioid users in the U.K. The highest number in Europe.

Is this a wake up call and time to get real?

Share your thoughts below, id love to hear them!

Maiya Ahmed, Clinical Pharmacist and Director.

One thought on “The Opioid Crisis- Time to get real?

  1. Maiya I came back to this article because it has been discussed where I am working in Australia. It was following this statement.

    As an anaesthetist we are predominantly responsible for prescribing post-op analgesia to our patients and opioids are some of our most effective. We have to take responsibility in sensible and safe prescribing and putting effective limits on our prescriptions especially those that are taken home. Utilising regional anaesthesia and alternative multi modal analgesia is key but would necessitate a change in culture to be more widely accepted.

    Your statement “Studies show that up to 30% of people who are prescribed opioids misuse them, 80% of people who use Heroin first misused prescription medications”. Can you message me the links to these studies? I want to use it in the discussions in my hospital.

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