Probably Shelly Lewis summed up the American opioid crisis with when she said, "Addiction is a family disease. One person may use, but the whole family suffers." Drug abuse and the menace it causes can be seen or felt everywhere in the American system, such as regular drug tests in workplaces, the development of well-organized drug business, including ruthless drug cartels and thanks to the growth of technology, online drug-related transactions. Drug abuse and the drug trade has been liable for the numerous assassinations, murders, and other criminal activities in the country. Drug abuse is one of the most regular topics of public discussion over the years with numerous campaigns to raise awareness and behavior change, yet this has done little to hinder the growth of drug abuse in the USA public. It has reached a point that drug abuse has been classified as a national public health enemy number one, yet this has not stopped drug addiction from becoming such a normalized storyline, as seen by numerous publicized celebrity cases and extensive network of drug addiction recovery centers. Sadly, some medical practitioners and public officials are culpable for some of these drug problems, as for one, prescription drugs, which include many opioid drugs are some of the leading drugs abused. Many are acquired over the counters, and more are synthesized by chemists who have a vast understanding of chemicals and their effects on the human body. Illegal prescription procedures and ‘pill mills contribute a significant part of the drugs abused. This paper examines the opioid epidemic that has plunged the USA public over the last few decades, giving different perspectives about the opioid drug abuse, the trends and the developments over the years. The paper seeks to identify the history of opioid drug abuse and different ideas about what can be done to improve the situation in the country.
When the question of what are the major challenges facing the world today pops up, drug trade and abuse will pop-up among the most critical. Drug abuse is the single largest cause of accidental deaths and overall deaths for people under the age of 50 years. Over the years, numerous laws have been created and changed with the hope of restricting this societal vise, but ironically, and sadly, similar to the climate change, these efforts have only risen public awareness and attitudes (Day 283). Similar to climate change, drug abuse has steadily risen over the years. In tracing the history of drug abuse and drug bans, many drug wars have offered mild success rates to the governments who waged them. For instance, 1920-1933 ban the ban on alcoholic beverages in the USA only lasted for 13 years and is regarded to be a failure. While the ban was good-natured, targeting to solve societal problems such as poor health and hygiene, alcohol abuse and the arising complication, and high crime rate, it was more famous to the creation of smuggling gangs and creation of gangster culture in the country. The prohibition had huge gaps in implementation such as the level of commitment in the national and state/local level of governance and poor financial resources to reinforce the ban and the resulting to increased interest in alcohol consumption (Day 285).
The alcohol ban was seen an opportunity for other entertainment outlets such as the soft drink industry, sports and movie theatres yet instead; it created a gloomy atmosphere as lack of liquor made entertainment joints less interesting. Ironically, pharmacies were allowed to sell whiskey as a prescription drug for different ailments such as dementia, and bootleggers saw this as an opportunity to sell drugs. In the decade, the number of pharmacies increased while home-made distilleries multiplied as people became alcoholic drink-making experts (Day 285). The country lost money from reduced taxes, efforts to fight the drugs resulted to an increase in the number of incarcerated people which increased state expenses and it created more alcohol addiction and deaths from impure illegal alcohol. In the end, the government abolished the ban which stabilized the economic disparity that was triggered by the ban. Similar to liquor the USA government has banned numerous drugs which were once accessible to the public such as cannabis, opium, heroin and cocaine. However, some of these drugs’ abuse increased after the ban and marijuana, heroin and cocaine have ended up entrenched to the American history and culture. Cannabis had been highly popularized in movies, music and other forms of artistic expressions long before the state finally lifted the ban on the drug. However, the rates by which these drugs are abused are lower than the abuse rates for prescription drugs in which many opioids fall under (Singer, 155).
Addiction is a situation by which something that started out as pleasurable or a necessity progressively grow to a point one feels they cannot live without. There are numerous types of addictions from addition to gambling to drug addiction. Medical practitioners describe drug addiction has to have strong urges to consume a drug, uncontrollable and continuous use of a drug despite its negative influence (Davis 97). For one, opioid addiction/ use disorder entails the sting desire to use opioids and trouble reducing use, increased tolerance that leads to the gradual increase in the ‘desired' dose and withdrawal symptoms which arise when one tries to quit. Addiction is a societal problem as it leads to poor relationships, loss of family and friends, poor performance in the workplace and schools and leads to high crime rates. The use of opioids has been a leading cause of HIV/AIDS infections especially among heroin addicts who share injection tools, have a high prevalence to commit suicide and lead to poor quality of life (Rollins 110). Sadly opioids, are the leading causes of accidental deaths in the American society leading to the loss of influential people such as celebrities, the most recent high case being Prince, a prominent musician (Coghlan 22). The high level of tolerance and drug abuse among celebrities has also played a significant role in influencing societal attitudes towards drugs such as the alluring depiction of drug abuse in films and references in music content. Opioids were originally designed as analgesic drugs, but with time, it was documented the drugs were also highly addictive, but by then, the supply of opioid in the USA was more than was needed. This also meant that the likelihood of misuse would be higher such as it is today where illegal channels of acquiring drugs have been prevalent (Partain and Mihir 885).
Drug addiction has been synonymous with the American culture ever since the rise of the opium trade and the resultant nationwide ban in 1860. The country also increased efforts to increase regulation of drugs by providing laws which ensured pharmaceutical companies labeled their drugs pointing out their negative effects on the bottle/package labels and fines for pharmaceutical companies which failed to label or misrepresented their products. The war on drug gradually included restricting the buying and selling to only certified pharmacies and physicians, but the rates of drug abuse in the country continued steadily as the bans seemed to become even tougher (Partain and Mihir 885). Many are the times that drug addicts were arrested, locked up and died in prison from withdrawal effects of drug abuse before the problem was identified as a disease in the 1960s. During the peak of drug wars in the early part of the 20th century, the government resulted in different tactics such as public information advertisement and warnings using credible sources such as church ministers and doctors. Furthermore, the government agencies made films which spread information and propaganda about drug abuse and drug abusers which led to the heavy stigmatization of drug abusers. However, this did not hinder the use of drugs as the number of drug abusers increased in the county by the decade.
In 1971 a report that claimed between 10-15% of soldiers in the Vietnam War was suffering from heroin abuse, and following the surge in drug abuse deaths, the government declared the drug abuse ‘public enemy number one’ and opioids prescription declined for the next decade. "Addiction Rare in Patients Treated with Narcotics" an article written Porter and Jick for ‘The New England Journal of Medicine’ in January 1980 heavily influenced the surge of opioid drug prescription in the country as it implied that the medical use of opioids has lower levels of addiction tendencies (Koh and Parekh 1438). In 1992 another report claimed that about one-third of the American public was suffering from chronic pain which led to increased efforts, both by the federal government and the pharmaceutical companies to increase the number and availability of prescription drugs in the country (CDC 1). Reinforced with campaigns and articles supporting the Porter and Jick report and recommendations by several commissions for physicians to have more pain-attentive Medicare, the 1990s was characterized by increased over prescription of several varieties of highly potent opioid drugs. Furthermore, many pharmaceutical companies assured the USA that there would be no opioid addiction as they had developed several counter-measures to prevent the pills from becoming addictive. This led to the increased preference of opioid drugs over other analgesic drugs such as aspirin in the USA, a phenomenon which is experienced up to date. In the first two decades of the 21st century has seen the decline of non-opioid analgesic drugs from a market share of 36% to 29% as the sales of the opioids soared. Day (283) notes that between 1991 and 2011, the number of prescription rose from 79 million to 219 million annual opioid prescriptions. The progression of laws that made prescription more restrictive in attempts to curb the opioid dependency resulted to a higher number of the drug users opting to acquire them through illegal means such as drug trafficking, prescription medicine from friends or relatives (Coghlan 23). It has also increased the availability of black market drugs such as heroin laced with impurities such as fentanyl which is highly potent and results in high rates of a drug overdose.
Opioids are some of the most highly abused drugs in the world and quite heavily in the USA. Opioids cut across both legal and illegal drugs and include drugs such as heroin and most painkillers used expressively in the USA such as oxycodone and morphine-based drugs (Rollins 110). Opioids have been used over the years, and their use was also largely influenced by studies that estimated that roughly one third off the American public suffered from chronic pain which triggered a massive wave of over-prescription of painkillers in that decade. Opioids are considered stronger painkillers than other painkillers such as aspirin which makes them the most likely form of painkillers available. Opioids act by primarily affecting the nervous system to relieve the use from pain while also inducing euphoria among the users, an ideal drug abuse trigger (Furay and Neumaier 2157). Opioids affect the nervous system by binding into the opioid nerve receptors, which predominantly send pain and reward messages to the brain. By binding into these receptors, they reduce the sending of messages to the brain that reduces the sensations of pain. Opioids are such powerful painkillers; they are used to treat severe pain that may be lowly responsive other pain treatments (Furay and Neumaier 2157).
However, when used continually or for the wrong use, opioids induce physical dependency as the body becomes more tolerant to the effects of the drugs, requiring higher/more frequent doses of the drugs to relieve the pain/reach the same high. Furthermore, continued use can lead to strong withdrawal symptoms when the user tries to stop using them, triggering dependency and strong addictive tendencies in the long run (Furay and Neumaier 2157). Opioids can lead to addiction as they trigger the release of endorphins, which are the brain’s good feeling transmitters. These blanket over the pain (either physical or emotional) while also amplifying feelings of pleasure making one feel at peace and well-being, but only temporarily as the drug wears out. Afterward, the user may miss the sensations and want to get back to that state as soon as possible, steps that progress into an addictive level where one becomes dependent on such a drug (Cooper et al. 299). Addiction merely starts as something which is pleasurable until it reaches a point one cannot live without.
When one takes opioids for an extended time, the drugs influence the production of endorphins which lead to urges to use more doses of the drug to reach the desired state of the body. Due to drug use control in medical facilities, the user may opt to acquire the prescription opioids or the illegal opioids such as heroin which is stronger, yet more dangerous than the medical opioids. Illegally acquired drugs mare be more potent or with higher impurities such as fentanyl which is highly potent and can quickly escalate to overdose and de As Carbone (54) notes, overdosing on opioids leaath.ds to complications in the respiratory system by blocking oxygen from reaching the user’s bloodstream hence leading to suffocation. It becomes even worse as the user dies in a euphoric state hence may not be fully aware as he/she suffocates to death (Mann and Carr 259).
The word opioid is derived from opioid receptors which form part of the nervous system. Opioid receptors, on the other hand, derive their name from the word ‘opiate,' which stands for drugs retrieved from opium. Most opioid receptors are found in the brain and the spinal cord with some extra concentration in the digestive tract. The opioid system has three different receptors; the mu-opioid (μ-opioid receptor, MOR), delta-opioid (δ-opioid receptor, DOR) and kappa opioid (κ-opioid receptor, KOR) receptors (Iegorova et al. 108). The mu-opioid receptors can be altered either by endogenous opioids such as endorphins or endorphins or by exogenous chemicals such as opioid drugs such as morphine, triggering the brain's reward systems which influence addictive habits. They also trigger the brain to induce compulsive demands cravings and relapses in demand for the rewarding behavior, the drug consumption (Iegorova et al., 108).
The endogenous opioid system in the body is believed to act as a regulator in creating social bonds such as friendships, emotional relationships and social attachment. The internal system induces either agonist chemicals which serve to create a feel-good towards certain social contexts or antagonist chemicals which block the effects of agonist chemicals hence influencing one's choose preferences (Furay and Neumaier, 2157). Similarly, opioid drugs have different effects to the opioid system as some such as morphine or heroin are agonists hence reinforce the addictive tendencies in the body. However, some opioids such as naltrexone and naloxone block the effects of agonist opioids hence can be used to manage different bouts of drug/opioid dependency. Antagonist opioids are commonly used to decrease the risk of opioids misuse (by combining them in the same pill), treat drug addiction and drug overdose emergencies by helping stop the effects of the overdosed chemicals (Massey et al. 975).
As opioids bond with the receptors in the brain, they create the opioid effect which numbs pain by slowing/ stopping pain messages from reaching the brain slowing up breathing and gives the body/brain a sensational calming effect. Normally, the body through the endogenous opioid system can produce these chemicals, but it is unable to produce them in levels potent enough to numb chronic pain nor cause an overdose (Kaafarani, 48). That is where exogenous agonist opioids take the prime value as they can amplify the effects of the internal mechanisms hence able to numb the severe pain. However, a majority of the opioids form temporary bonds hence wear out with time, calling for additional doses to maintain their potency. Mann and Carr (259) point out that while exogenous opioids mimic the endogenic ones, they also cause abnormal messages to the brain that cause the flooding of the neural system with dopamine. Dopamine is a hormone which largely affects the areas of the brain that regulate cognition and muscle movement, emotions and motivations, and pleasure. This makes it easier for the brain to send signals that the activity (drug consumption) is vital to the body system hence sending signals to demand more. Mann and Carr (259) also point out that taking large amounts of opioids leads to a higher depression effect on the respiratory system, leading to suffocation as muscles relax preventing oxidation in the bloodstream.
Opiates are drugs which are retrieved from opium, the original plant which was used as a recreational drug as it creates euphoria among its users. Opium was also used for its medical properties which enables it to help numb pain among patients. Upon the realization that opium was highly addictive, its use was banned in many countries especially the USA (Schuckit 362). However, its extracts were used to develop opiate drugs such as morphine, thebaine, heroin and codeine. Opioids, on the other hand, is a more general term for all drugs that bind with the opioid receptors (as not every drug that binds with opioid receptors is retrieved from opium) ( Iegorova et al. 109). There are more than 500 different opioid binding molecules that have been developed although a good number of them are not generally common hence unlikely to be abused. Some of the opioids which are not opiates include fentanyl, oxycodone and methadone among other opioids (Kaafarani 48).
Most opioids are drugs which run across the line of legal and illegal substance. This has made it easier for the American public to have much easier access to these drugs. However, the opioid use has worsened over the years, with deaths due to opioid overdose having quadrupled since the year 2000 to date. Ricker and Davis (2017) note that the rate is rapidly growing with a 21% increase in opioid overdose between 2015 and 2016 and a rate exceeding 91 deaths from heroin overdose each day. This grew tremendously to 130 opioid overdose deaths per day in 2017, causing the death of over 72,000 American, something that is expected to rise in 2018 (HHS, 1). In the last five years have seen a sharp rise in the casualties of opioid abuse even as measures to curb the menace seem to have become more advanced. However, some of the means opted such as control of legal opioids has led to increased use of illegal drugs such as heroin which is quite accessible in the American streets. Furthermore, some of these illegal drugs have been corrupted by impurities including stronger opioids which makes them more potent in the same dose that abusers are normally used to hence causing accidental deaths. NCIC (1) note that half of the opioid overdose is accidental while one third is deliberate. Several methods have been used to curb the drug menace especially using legal means, but it seems drugs got smarter because over the decades' drug abuse has always been in an alarming ascension. Some pharmaceutical companies tried mixing the opioids with control chemicals such as antagonistic opioids but this has done little to curb the abuse (Schuckit, 361).
Several methods have been developed in efforts to curb the drug menace. Krebs (25) urge that the effectiveness of eradicating opioid epidemic in the country is first accepting the situation, acknowledging the people suffering from opioid use disorder and show care which can help them open opportunities to change without fear of suffering from embarrassment or stigmatization from the society. Several intervention methods have been development amid contrasting opinions about their role in eradicating opioid abuse.
Opioid drugs are the most addictive drugs according to Lachenmeier and Rehm (8126), piping over other famous addictive drugs such as cocaine and tobacco. This makes the treatment highly sensitive as patients can easily relapse. Opioid treatment generally includes medicinal and behavioral therapy as it is typically ineffective to try either of the two methods alone, although medical treatment alone has an upper edge when used alone. There are several strategies used which involve treating withdrawal symptoms, and create attitude and behavior changes.
Apart from Narcan, buprenorphine (Subutex) is also used to treat opioid addiction as it is a non-selective agonist-antagonist which can help recovering addicts through the withdrawal effects of the drug. Similarly, methadone, another mild opioid can be used as an alternative treatment drug as it is a long-acting opioid hence can be used once a day rather than using heroin multiple times a day. In the USA, using buprenorphine for treatment is much cheaper as it can be prescribed/administered by a physician in normal hospitals, unlike methadone which is usually administered in controlled environments at rehabilitation clinics. Medical treatment seeks to detoxify the body by treating the withdrawals symptoms and cravings while gradually suppressing the effects of ‘high’ which makes opioids addictive (Schuckit 363).
Behavioral treatment usually seeks to reinforce the person’s behavioral change by engaging them in positive activities, enabling patients to have a positive experience. There are several tactics that patients can use as behavioral treatment therapies such as group therapy, engaging in group discussions about life experiences and how to change, individual therapy sessions and engaging in twelve-step programs. Behavior therapy is quite challenging due to the prevalence of relapsing and long time it may take to impact a person's behavior. However, it helps patients reduce negative thinking, get inspired to set goals to replace negative behavior, boosts self-esteem and enable the patients to be able to help others, which is important in fighting opioid abuse (Davis, 109).
While professional help might be a seemingly easy decision, it has a low participation rate, as only about 1-5% of drug abusers willingly attempt it. It is perceived to be profoundly degrading for drug abuse, of whom many do not treat as a disease. Schuckit (360) point out that care and sensitivity are important in inspiring opioid abusers to see beyond the embarrassing nature of opioid use disorder treatments. The American public has been criticized for opting to use the ‘pill’ as the solution to every problem that comes their way rather than opting to use better means such as social interactions, therapy and exercise. This has made easier to create dependency for every problem from pain, to depression and hangovers/fatigues. Kaafarani (48), suggests that this can be minimized by avoiding prescribing pills as part of almost any psychological problems and minimize the consumer advertisement of drugs to balance with public information on holistic integration of personal health. This includes emotional, spiritual, physical and psychological health that are prime targets of the ‘feel good’ feelings from opioids.
Getting Medical Insurance – The current medical insurance system makes both public and private medical insurance quite complicated especially for those who do not meet the standards to receive the public insurance. This makes it easier for them to opt for cheaper prescription drugs for mild health issues rather than seeking professional checkup, making a large part of the American population susceptible to abuse drugs (Krebs 25). The Department of Health And Human Services (2) show that in 2017 alone, about 2 million people abused prescription drugs for the first time in the country, with about 81 thousand abusing heroin for the first time. This calls for some reforms in the insurance policies or medical checkups that can encourage people to seek formal interventions rather than ‘promoting themselves to medical practitioners, specialized in knowing which drug to kill the pain.'
Safe Injection Zones – Several states and nongovernmental organizations have encouraged the development of safe injection zones and public supply of injection materials to drug addicts. The safe injection zones include designated places where opioid users can inject themselves/consume opioids but with close monitoring by social/medical workers to minimize the cases of drug overdose or death as a result. This has been criticized as giving the green light to drug abuse further escalating the problem. This has made the government and several stakeholders apprehensive in testing it out not to seem to support opioid abuse or other related problems such as trafficking. However, those for it argue that these places and distribution of materials helps minimize the spread of diseases such as HIV/AIDS among drug abusers, collect data, show love and minimize death by overdose which can be prevented (Krebs 25). Furthermore, these safe zones have shown the care that most addicts need hence making some willing to seek treatment for their dependencies. They also help reduce stigmatization which is an important part in combating the opioid epidemic (Press Herald 1).
A new concept of the use of naloxone, publicly known as Narcan as a opioid overdose and emergency control measure has been widely introduced with a strong debate. Opioid overdose is the most common cause of accidental deaths in the USA and Narcan is on antagonist opioid which was developed with the hope of reducing this fatality rate. Narcan is used in opioid overdose emergencies by reversing the effects of the agonist opioid. It is directly injected into the victim's bloodstream or by a nasal spray which rapidly stops the respiratory system depression, enabling the victim to start breathing normally once more (Ricker, 1). Heroin is one of the most abused drugs in the country and is usually cheap and readily available through illegal meanwhile the treatment for overdose has also been scarce (Rollins 111). Furthermore, many illegal drugs are usually laced with impurities especially stronger chemicals such as fentanyl which has resulted in high levels of the accidental drug overdose for people who normally use these drugs recreationally. Furthermore, the law in most states restricts buying drugs to prescriptions given by certified medical practitioner making the access of the drug quite hard especially in emergency situations. People have resulted in having to wait for emergency services to come to the rescue, which is quite inconvenient and as they are likely to arrive late (Carbone, 55).
Narcan has been responsible for so many drug overdose reverses that it is commonly referred to as a typical ‘life giver.' However, as Narcan's use becomes more popular, so does the rates of drug-related deaths in the country, currently reported at ten people per 100,000 people annually. This is even worst in some states such as New Hampshire whose drug-related death cases are about 30 people per 100,000, recording opioid overdose deaths from 169 in 2012 to 396 people annually in 2016. This is as surprising as the rates of Narcan saves have increased dramatically in the State (Ricker 1). Opioid-related death rates are even more prevalent among Native American and in rural areas where the population is scarcely populated. The opioid deaths have been growing so highly that between 1994, rural deaths grew by 159%, a death rate further escalated by the fact that distances in rural areas are larger hence emergency services might take longer (Faul et al., 28). Furthermore, there are lower numbers of emergency personnel, which severely minimizes the chances of surviving an overdose episode. There have been heavy suggestions that if Narcan is distributed to relatives or friends of people with a history of drug abuse or people who are likely to experience drug-related emergencies such as community workers as this can make the drug closer to the victims of drug abuse. However, this is one of the many contradicting perspectives on how Narcan can be handled in the population. Other people feel like the supply of Narcan should also be controlled to minimize drug abuse as its availability can encourage the drug abusers to be riskier, hence reinforcing the drug abuse (Ricker, 1).
The people in support of Narcan point out that relatives or friends can handle opioid-overdose situations better if Narcan is readily available over the counter considering Narcan is not lethal even when taken in larger doses as compared to other opioids (Ricker, 1). This can help save many more lives that currently being done. For instance, supplying 50,000 units of Narcan kits to community workers across the country enabled them to save at least 10,000 people, yet the rates of deaths from overdose were also on the rise. In increasing the availability of Narcan, the mortality rate can also be further reduced (NCIC, 1). It prevents unnecessary deaths including those caused by waste of time, unnecessary costs such as high transportation costs, the payments that have to be made to emergency workers and maintenance of emergency facilities that can be used for emergencies that need more attention from the medical practitioners. The type of emergencies which can be affected by time delays have high impacts on performance levels such as the $ 20.4 billion the government had lost in the cost of medication and loss of productivity by 2009, something that even improved technology has been unable to reduce (Hodgson 1). The ever-increasing emergencies can become overwhelming for emergency personnel – considering not all emergencies are drug-related. If some of these emergencies can be managed without the need for professional medical practitioners, the better the emergency services can be utilized.
The increased deaths and costs of treatment are making the war on drugs feel like an eternal one; hence it will always be better to have stronger prevention measures. Taking an example with the Pre-exposure prophylaxis (PrEP) used as a preventive drug in the exposure to HIV and which has helped to reduce cases of new HIV infections dramatically, the same case can be used for Narcan, making it more available hence making it more available to the public. This can be done by ensuring the primary preventive care which can be given by people closest to the drug abusers is reinforced. Easier access to Narcan and other preventive drugs can include policies that do not require one to have a direct recommendation from a medical professional for them to buy Narcan. The country is making this possible by enabling the sale of Narcan in specified pharmacies across the nation as it seeks to implement a strategy to end the opioid public health emergency.
Several points have been raised over how drug menace can be controlled with some of them offering some radical moves such as legalizing the said drug which can make them more interesting to the public. They derive their argument from the point of view that humans are relatively curious and are likely to try out illegal substances, but if they are legalized, they will lose value hence their fatality rates will reduce (Ricker, 1). The availability of Narcan to the public may create the impression that this is the cure to the opioid addiction. This may encourage the public, including non-addicts to misuse opioids which can escalate the drug crisis, with the reinforced attitude that ‘After all there is a cure in case we overdose,' resulting in a worse rate of drug abuse of which the nation is trying to eradicate in the first place (Faul, 1).
A faction of people against public access of Narcan also feel that people may start using the drug to cure their illnesses rather than seeking proper medical attention. People may start asking why they would go to rehabilitation centers, yet they could simply take drugs, and take Narcan, and in a snap, they will be back to normal. Statistics point out that roughly 1% of drug abusers ever get to rehab, which is quite low and will be even lower when Narcan becomes accessible to the public (Singer, 155). Furthermore, current studies show that administering of Narcan has been associated with a huge number of drug addicts/ drug abuse casualties refusing or failing to go to the hospital for further check-up hence hardening their stance with drugs since they recover very quickly (Ricker, 1). A major point of concern noted by emergency services is that majority of the people who abuse drugs to the point of overdose are usually the same, same people. It becomes frustrating that the brushing with death does not seem to change their perception or make an effort to change their drug abuse tendencies. As a Maine police officer observed, to a good number of drug abusers, ‘offering Narcan publicly will just help them extend their lives until the next overdose. Offering the ‘miracle drug’ publicly will not help curb opioid abuse, but rather make the abusers feel safe while abusing them, further making them more reckless (Massey et al., 977).
There are several ways the public can help win against the opioid epidemic in the country. It is tough to allow the opioid antidote –Narcan- to public access as they are highly likely to misuse and abuse it which calls for the decision to be based on the moral consequences of making the decision. The positive part of allowing Narcan to be accessible over the counter, it can lead to increased survival rate hence, which goes directly proportional with medical ethics that the goal is to alleviate pain and save lives in every ethical-sound means possible, which will curb the negative consequences of opioid abuse to the society. It also gives the patients new opportunities to seek treatment, something which would not be there if they are dead due to the manageable medical emergency. As Mitchell (2) point out, it has been difficult for people struggling with drug problems to get resources as the process can be embarrassing and hard to manage. There usually a narrow window for drug abusers to seek assistance before giving up and engaging deeper in drug abuse. This calls for more training for members of the public to have a better awareness from a drug abusers' perspective to show empathy that can motivate them to make efforts to change. It also helps defend some radical measures such as providing injection tools or the safe injections zones, which might seem as promoting opioid abuse, but it rather helps incorporate the opioid abusers with a positive social environment that can encourage them to finally make efforts to get professional treatment. Rollins (110) note that while addiction is a disease and death the worst and the last symptom of opioid abuse, battling this symptom out and defeating it will be a massive step in stopping drugs from overwhelming our society.
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