Louis Ariagno
Kathryn Calkins
English 1A
29 November 2018
The Disaster Around the Opioid Epidemic
Every year, thousands of men and women are dying due to the misuse of pharmaceutical drugs. In 2016 alone, over 42,000 people had suffered an overdose due to the improper use of prescribed and non-prescribed opioids (National Institute on Drug Abuse). The opioid epidemic has swarmed the United States into a crisis, which has led to many companies losing billions of dollars. How might this be? In the 1990s, pharmaceutical companies had informed the medical community in regards to the use of opioid pain relievers by ensuring them that patients would not be addicted to them. Due to this mass introduction of “non-addictive” pain relievers, doctors began to rapidly prescribe these opioids at greater rates than before (Morone & Weiner). Soon after the great introduction of opioids, it had become clear that these opioids were extremely addictive, eventually leading to the yearly increases in opioid overdoses. Codeine, Morphine, and Oxycodone are just some of the most used opioids today, which are influencing the deaths of more than 115 people everyday (National Institute on Drug Abuse). Throughout the opioid epidemic, it has become evident that the economic burden on the United States has been quite dramatic and that the pharmaceutical companies did not properly warn users of the addictive side effects (Inocencio et al.). This epidemic needs to stop.
Ever since the beginning of the opioid epidemic, companies have been losing millions of dollars everyday. In fact, in 2009, the total costs had peaked to a whopping total of $20.4 billion (Inocencio et al.). This is mainly due to the uninsured people arriving to hospitals during an overdose. Then as these people die, the hospital is left in debt with no one left to pay the bill. This will sometimes be the same for those with insurance, due to some insurance companies refusing to cover the costs. A recent study has shown that one hospital billed $17.3 million to insurance companies, while only receiving a total reimbursement of $3.8 million from these companies (Lagasse). Due to this issue, the cost of treating opioid addiction and overdose has risen. Insurances have decided that raising large employers’ coverages would be the best way to replace the money that they have lost (Cox et al.). This means that this would directly affect the employee’s insurance premiums at these large firms, such as hospital employees. But what is directly leading to these costs? The majority of the costs are mainly due to all the deaths caused by these opioid overdoses. Ambulance, hospital, and inpatient costs are all very expensive services that end up unpaid due to the death of these victims (Inocencio et al.). Over twenty billion dollars of all the overall costs from the epidemic can be accounted for in response to the high mortality rates (Inocencio et al.). This means that all the resources used for these diseased patients have gone to waste with no reimbursement from the insurance companies or anyone to pay for the bills. Overtime, these costs have led to the lost of billions of dollars every year and have truly caused an economic burden on the United States. However, the economy is not the only thing being affected, people’s lives and health are also at stake because of the use of opioids.
The opioid epidemic has impacted many individuals through addiction. Addiction can cross every threshold of society and affect anyone no matter who they are or what they do. Upon an interview with a certified substance abuse counselor who currently works at a detoxification center, Neil Hopper, stated that, “next to alcohol, opioids are one of the most common substances that people come to treatment for” (Hopper). Opioid addiction has severe physical effects on an individual making the withdrawal process one of the most uncomfortable. Individuals who go through opioid withdrawal will often suffer from withdrawal symptoms after they complete a detox. These are called Post Acute Withdrawal Symptoms, also known as, PAWS (Pit et al.). “It is common for many to relapse while experiencing the post acute withdrawal symptoms due to the physical and mental discomfort” (Hopper). Depending on how long the individual has been using, someone could experience long-term gastrointestinal issues and difficulty regulating their body temperature and many more long-term symptoms. This shows that the recovery process for overcoming an opioid addiction can be physically and mentally draining on the individual and their loved ones. Alongside the physical irritability that comes with opioid addiction, there are often many strains on relationships within an individual's support network. Hopper stated that having support through recovery is one of the biggest factors when someone is working through their addiction (Hopper). Humans are social creatures and innately rely on one another. When the natural instinct of human connection is gone or ripped away, many who are addicted will continually turn to the drug. The opioid epidemic has affected more than just the individual whom is taking the drug; it has the potential to affect their whole family system. The determinate of this epidemic has caused many companies to take a look at this situation and adjust the way they look at opioids. Companies are now beginning to view a once common and effective painkiller as an addictive and potentially dangerous substance.
Ever since the outbreak of this horrific epidemic, the effects have ranged from financial situations, to health problems. As a society, it is extremely hard for people to focus on their lives, especially when they are affected by the opioid outbreak everyday. Whether it’s a friend who became homeless due to a developed addiction linked to opioids, or an increase in an insurance bill, it seems that everyone has encountered a situation due to the use of opioids (Cox et al.). In response to these circumstances, Paul Uhrig from the company, SureScripts, has developed an idea that could help change the future of the opioid epidemic. He states that by having an accurate, up-to-date access to a patient’s medical history, it would enable the doctor to be able to make the best, informed decision on how to treat a patient with a prior addiction. This means that a patient’s medical history must be in integrated within the prescriber’s workflow so that the doctor will be aware of all medications currently being used by that patient (Uhrig 2). By doing so, this will lead to a decrease of prescribed opioids leading to addiction. In addition, the United States Department of Health and Human Services, or HHS, is also battling the issue by focusing on priorities such as improving access to treatment and recovery services, as well as promoting the use of overdose-reversing drugs to the public (National Institute on Drug Abuse). By supporting such a cause, HHS and the National Institutes of Health, or NIH, hope to reduce the number opioid users in the upcoming years. In fact, in April 2018, the director of NIH, Francis S Collins, introduced a “HEAL” initiative, meaning “Helping to End Addiction Long Term”, as an effort to “speed scientific solutions to stem the national opioid public health crisis” (National Institute on Drug Abuse). This will surely support the hope to the decrease in opioid use in the United States. However, this will not always be the case. Recently, pharmaceutical companies have just released a new and stronger opioid to be used in hospitals.
There are plenty of opioids currently in the market. From Oxycodone to Heroin, these drugs are currently being used today by thousands of people in order to “cure” their pain (Lembke 3). Recently, however, the Food and Drug Administration, or FDA, has approved a new pain reliever, which is supposedly much more powerful than the previous painkillers on the market (Diep). Dsuvia, the newly introduced opioid, has become very controversial during the release of the drug. Although the FDA itself had approved of the drug, advocates from other companies such as the group, Public Citizen, have still publicly opposed the pain reliever stating that it will be “abused” and will start “killing people as soon as it hits the market” (Diep). Apparently, however, the FDA argues that the drug is needed for certain surgeries. They also say that the risks of the drug hitting the streets will be minimized, by keeping it in hospitals and other health care settings. Is this really the case though? Over the course of past years, these types opioids and substances have become more commonly seen on the news due to the abuse seen on the streets. This shows why people would be concerned with introducing such a powerful substance to the medical community. It has also been shown that the Pentagon has been interested in this drug as well. They were possibly hoping for its use on the battlefield, as a way for injured soldiers to relieve pain (Diep). Due to the increase in use however, the FDA have become aware of the possible cause of addiction. Therefore, they have now begun to focus on what the possible outcomes could be of releasing certain drugs into the world. Overall, the effects caused by the opioid epidemic have been too great to ignore. By introducing new pain relievers and focusing on the possible outcomes, people begin to lose trust in the medical community on their choice of decisions. Although there has been an attempt to change this current situation, it seems that the opioid epidemic has become too great to handle alone.
In conclusion, the opioid epidemic has led to plenty of issues within the United States. Overdoses, loss of family members, and a will to live are some of the variants included within this epidemic. Through the process of over-prescribing medicine, people have become addicted to opioids much more than before in recent years. As overdose rates spiked from five thousand people in 2014, to thirty thousand in 2017, it has become evident that there is an issue to be addressed (National Institute on Drug Abuse). Through economical, health, and life effects, it is plausible to say that almost everyone in the country have been affected or associated to the opioid epidemic in their lives. Due to this tragedy, people have begun looking for ways to resolve the horrible mess, which first began in 2002 (National Institute on Drug Abuse). However, the Food and Drug Administration is still approving new drugs to this day that have addictive properties to them. By doing so, these types of companies are taking a risk of a more powerful painkiller hitting the streets and possibly leading to an increase of overdoses. Overall, by informing the people of the United States to be aware of this ongoing crisis, the medical community will be able to prevent more people from being addicted to these drugs. Hopefully, there will become a day when these powerful drugs will not be abused, and will be used for the right reasons.
Works Cited
Cox, Cynthia, et al. “A Look at How the Opioid Crisis Has Affected People with Employer Coverage.” Peterson-Kaiser Health System Tracker, Peterson-Kaiser, 5 Apr. 2018, www.healthsystemtracker.org/brief/a-look-at-how-the-opioid-crisis- has-affected-people-with-employer-coverage/#item-start.
Diep, Francie. “The FDA Approves a Controversial New Opioid Painkiller.” Pacific
Standard, Pacific Standard, 2 Nov. 2018, psmag.com/news/the-fda-approves-a-controversial-new-opioid-painkiller.
Hopper, Neil. Personal Interview. 25 November 2018. Ariagno, Louis. Personal
Interview. 3 December 2018.
Inocencio, Timothy J., et al. “The Economic Burden of Opioid-Related Poisoning in the
United States.” Pain Medicine, vol. 14, no. 10, Oct. 2013, pp. 1534–1547. EBSCOhost: Academic Search Complete, doi:10.1111/pme.12183.
Lagasse, Jeff. “Opioid Epidemic: Here's One More Way It's Costing Hospitals
Millions.” Healthcare Finance News, 30 Apr. 2018, www.healthcarefinancenews.com/news/opioid-epidemic-heres-one-more-way-its-costing-hospitals-millions.
Lembke, Anna. Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and
Why Its so Hard to Stop. Johns Hopkins University Press, 2016.
Morone, Natalia E and Debra K Weiner. “Pain as the fifth vital sign: exposing the vital
need for pain education” Clinical therapeutics vol. 35,11 (2013): 1728-32.
National Institute on Drug Abuse. “Opioid Overdose Crisis.” NIDA, National Institute on
Drug Abuse, 6 Mar. 2018, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.
National Institute on Drug Abuse. “Overdose Death Rates.” NIDA, National Institute on
Drug Abuse, 9 Aug. 2018, www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.
Pitt, Allison L., et al. “Modeling Health Benefits and Harms of Public Policy Responses
to the US Opioid Epidemic.” American Journal of Public Health, vol. 108, no. 10, Oct. 2018, pp. 1394–1400. EBSCOhost: Academic Search Complete, doi:10.2105/AJPH.2018.304590.
Uhrig, Paul. “Changing the Course of the Opioid Epidemic: The Power and Promise of
Proven Technology.” Surescripts, 30 Apr. 2018, pp. 1–8.
Works Consulted
Cox, Cynthia, et al. “A Look at How the Opioid Crisis Has Affected People with Employer Coverage.” Peterson-Kaiser Health System Tracker, Peterson-Kaiser, 5 Apr. 2018, www.healthsystemtracker.org/brief/a-look-at-how-the-opioid-crisis- has-affected-people-with-employer-coverage/#item-start. This article provides facts regarding the increase of insurance premiums due to the opioid epidemic. This will help show how the epidemic is affecting most of the population.
Diep, Francie. “The FDA Approves a Controversial New Opioid Painkiller.” Pacific
Standard, Pacific Standard, 2 Nov. 2018, psmag.com/news/the-fda-approves-a-controversial-new-opioid-painkiller. This article provides insight on the new, controversial painkiller that the FDA has recently approved. This will help to inform the readers that this crisis is still occurring.
Esch, Caitlin, host. “The sentence that helped set off the opioid crisis.” The Uncertain
Hour, Marketplace, 13 Dec. 2017. https://www.marketplace.org/2017/12/13/health-care/uncertain-hour/s02-4-sentence-helped-set-off-opioid-crisis. This podcast provides quotes regarding how pharmaceutical companies tricked and manipulated users through product descriptions. This will help support the argument that companies are not properly warning consumers.
Hopper, Neil. Personal Interview. 25 November 2018. Ariagno, Louis. Personal
Interview. 3 December 2018. This personal interview with a certified substance abuse counselor will help the readers gain insight on more everyday effects of opioids. This will help show more negative effects of opioids to the readers.
Inocencio, Timothy J., et al. “The Economic Burden of Opioid-Related Poisoning in the
United States.” Pain Medicine, vol. 14, no. 10, Oct. 2013, pp. 1534–1547. EBSCOhost: Academic Search Complete, doi:10.1111/pme.12183. This peer-reviewed article helps show the economic effect the opioid epidemic has had on the country and pharmaceutical companies. This will support my essay by providing facts regarding how the epidemic is benefiting companies.
Lagasse, Jeff. “Opioid Epidemic: Here's One More Way It's Costing Hospitals
Millions.” Healthcare Finance News, 30 Apr. 2018, www.healthcarefinancenews.com/news/opioid-epidemic-heres-one-more-way-its-costing-hospitals-millions. This articles provides information and statistics regarding the effects the opioid epidemic has caused on hospitals. This will help develop a more argumentative stance against the opioid epidemic.
Lembke, Anna. Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why Its so Hard to Stop. Johns Hopkins University Press, 2016.This e-book provides personal experiences of people affected by the opioid epidemic and facts on the issue. This will help support the argument of the negative affects of addiction and facts regarding the controversy.
Morone, Natalia E and Debra K Weiner. “Pain as the fifth vital sign: exposing the vital
need for pain education” Clinical therapeutics vol. 35,11 (2013): 1728-32. This article provides insight on the way doctors prescribe opioids to patients. By incorporating this document, the readers will understand what helped lead to this epidemic.
National Institute on Drug Abuse. “Opioid Overdose Crisis.” NIDA, National Institute on
Drug Abuse, 6 Mar. 2018, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis. This article provides facts that show how the opioid epidemic started and why these events happened. This will help inform the readers of the true events that occurred that led to this epidemic.
National Institute on Drug Abuse. “Overdose Death Rates.” NIDA, National Institute on
Drug Abuse, 9 Aug. 2018, www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. This article provides statistics and facts regarding the overdose rates within the United States. This will help to provide accurate numbers of the deaths caused by the opioid epidemic.
Pitt, Allison L., et al. “Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic.” American Journal of Public Health, vol. 108, no. 10, Oct. 2018, pp. 1394–1400. EBSCOhost: Academic Search Complete, doi:10.2105/AJPH.2018.304590.This peer-reviewed article provides insight of the effects that opioids can have, both positive and negative. This will be used to build up the argument of how bad opioids are.
Uhrig, Paul. “Changing the Course of the Opioid Epidemic: The Power and Promise of Proven Technology.” Surescripts, 30 Apr. 2018, pp. 1–8.This article provides insight on helping to change and stop the epidemic. This will fit in the essay by providing enlightening details of what is happening to stop this epidemic.