The United States is currently watching a dramatic impact of the misuse of opioid prescription medications. It is particularly easy to become addicted to opioids. A few examples of opioid drugs are but not limited to: codeine, fentanyl, heroin, morphine, and more. When the drug enters the bloodstream, it allows the opioid receptors to bind which reduces the sending of pain messages to the brain. They are powerful pain-reducing medications that help regulate pain when prescribed for the right conditions and when used properly. But when they're exploited, they can cause severe harm to the body, including addiction, overdose, and death. Recently, large numbers of citizens have been significantly impacted by the negative effects of opioids. Physicians, nurses, and other certified positions should be more careful when distributing prescriptions to patients as they can be falsely prescribed and used in an illegal manner.
Opioids are distributed frequently and carefully for chronic pain. Federal laws are supposed to monitor the possession and distribution of all opioids, but these laws alone are not always effective enough to keep opioids from being used recreationally. In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers. This statistic shows that approximately everyone in the U.S. could have had a prescription for opioids in the year 2014. One of the major sources of diverted opioids were from physician prescriptions. Recently, physicians and medical associations have began to question prescribing practices for opioids as they admit to being unconfident while prescribing them safely. These health professionals should retain more knowledge about whether, when, and how to prescribe opioid painkillers without increasing health risks. “Every other developed country does at least as good or as poor a job as we do managing pain — while not using opioids at anywhere near the same level.”(Keith Humphreys) The U.S. has consumed a substantial amount of opioids compared to every other country, becoming the leading opioid prescriber due to pharmaceutical companies wanting money and doctors pressured to treat their patients quickly and efficiently. Health professionals should take more time with their patients to help them get better instead of handing them a prescription for opioids to take the pain away.
Patients are able to obtain prescriptions legally or illegally. Usually the patients who need the pain medications aren't the ones who become addicted. The main focus of the overdose epidemic was caused by drug companies that pushed doctors to prescribe unnecessary drugs, which turned innocent pain patients into people becoming dependent on different pain killers. Medical professionals may sometimes prescribe their patients opioids to get rid of pain to suppress their symptoms as soon as possible. This makes it easy for patients to fake injuries and get prescriptions for them to use illegally, which might lead to an overdose. Advancing the way opioids are prescribed through clinical practice guidelines can make certain patients have access to safer, more effective chronic pain treatment, while reducing the risk of opioid use disorder, overdose, and death.
The health professionals that have the permission to prescribe drugs might have been in an ethical dilemma while deciding if they wanted to prescribe opioids. Being that they didn't know wether or not to give a patient a prescription so they left it up to their ethics to decide. This dilemma has even been recognized by the government. As the National Academies of Science, Engineering, and Medicine released an official report on the crisis. This report inherently said that the Food and Drug Administration (FDA) is developing a formal method for incorporating individual and societal considerations into its risky framework for opioid approval and monitoring. Basic ethical regulations can provide a schema to help physicians make ethically appropriate decisions about opioid prescribing.
A subset of people who abuse prescription opioids may progress to other drugs such as heroin to feed the addiction for a stronger high. Frequent prescription opioid users and those with dependence or abuse of prescription opioids are more likely to switch to heroin. From the years 2002-20012, the incidence of heroin initiation was 19 times higher among people who reported prior non-medical pain reliever use than those who did not. This heroin use is driven by its low cost and high availability. Heroin and prescription opioids share similar chemical properties and psychological impacts on the body. Both are derived from the poppy plant and bind to the same group of receptors in the brain which can increase pain tolerance with the sensibility of euphoria. This increased tolerance can mislead the brain into taking higher dosages for the same effect. It soon became apparent that these drug abusers weren't going to stop as a result of the governments crackdowns or new technologies.
OxyContin, created in 1996, is an opioid that is prescribed for the control of pain severe enough to require daily doses. When The brand named OxyContin was first produced, it was prescribed freely for patients with any sort of pain. Around 6 million prescriptions were produced for this new drug in the year 2000 while every 2 out of 7 became addicted to it. The creators, Purdue Pharma, were charged $643,000,000 for over-marketing these highly addictive opioids. This product was more addictive than others considering that there is more oxycodone present in their formula.
Opiophobia is a real fear in health professionals where they are afraid to or unwilling to prescribe opioids to their patients. This has slowly increased a barrier to treating pain within certain patients. An international panel of pain specialists including physicians and health policy scholars met to discuss the impact of fear of opioids. This also addresses the issue of opiophobia and its impact on the effectiveness and quality for treatments of cancer or severe chronic pain. People with opiophobia tend to have some previous trauma as a root cause. Pseudo-addiction is another problem relating to prescribing opioids. If a patient has this, they often display drug-seeking behaviors while mimicking opioid use disorder, but are driven by their need for pain relief. Although this is slightly rare, cases may appear like this ever so often. Symptoms may include: knowledge on specific painkillers, over exaggerated pain, and constantly asking for more prescriptions. Many health care providers under prescribe painkillers because they overestimate the potential for patients to become addicted to medications.
When used correctly, opioids are very useful. They are able to help manage pain effectively only if used for a short amount of time. If used long term on a daily basis, patients should be monitored to make sure addiction disorders don't occur. Common reasons for use of opioids are: acute pain post surgery, injury or trauma, cancer pain, and pain arising from disease. Other reasons could be cough or diarrhea suppression. These are some of the most common clinical uses of opioids that help with pain. For many people, opioids have been remarkably helpful; for others, they either haven't worked or have created problems over time.
The usage of opioids can potentially cause common side effects. These can include: constipation, drowsiness, nausea, confusion, hallucinations, and dry mouth. Opiates usually produce a "high" of some type; the faster-acting they are, the more intense the high they produce. These side effects can worsen and become more severe if opioids are taken long term. Several clinical trials are currently underway to identify therapies that can reduce these side effects for patients. When patients take the opioids when instructed, these side effects may not occur or may be noticeably reduced.
In conclusion, opioids are very useful but getting addicted may be life threatening and can always be treated through therapy. Prescriptions can also be decided though the health professional's ethical dilemmas. They can also be given out to treat patients as soon as possible to save the health professional's time. Opiophobia and pseudo addiction are both real mental health issues that can affect the outcome of the patient's treatment of pain. Though side effects aren't severe unless dependent or addicted to opioids. Solutions of this opioid crisis can be to educate these education professionals, that have the ability to prescribe different types of drugs including opioids, to an extent where they always feel comfortable making a decision that will relieve the patient of their pain. Another solution is to increase the price of these opioids because they are so cheap and accessible, which is another reason why these people turn to them so quickly. Clinicians should establish treatment goals with all patients, including realistic goals for pain and function, and should consider how opioid therapy will be discontinued if benefits don't outweigh risks.
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