Substance abuse is one of the most acute and widely spread problems that American society is facing. Over recent years, the issue has become even more complicated due to the increased level of prescribed opioid abuse. This paper aims to address the issue and consider the measures of combating prescribed opioid epidemic in the USA on the national level.
Opioid Abuse Problem
Opioid abuse – understood as the intentional use of opioids to achieve a psychological effect – has been a severe problem for many years. As noted by National Institute on Drug Abuse (2020), “the misuse of opioids is “a serious national crisis that affects public health as well as social and economic welfare” (para. 1). However, this problem is becoming even more severe nowadays as the rates of prescribed opioids abuse disorders and deaths continue to grow.
Specialists found the root of this situation in the extended introduction of opioid-based prescription drugs in the 1990s. They are used for pain relief in acute and chronic settings and are deemed highly effective because of their “ability to interact with the family of opioid receptors that are variably distributed throughout the body” (Essack et al., 2016, p. 20). Between 1999 and 2013, “the amount of prescription opioids dispensed in the U.S. and the number of deaths due to prescription opioids have both quadrupled, with more than 16,000 deaths attributed to opioids in 2013” (Pon et al., 2015, p. 674). Both highly effective and addictive, opioid-based pain relievers are still widely prescribed and therefore abused.
Another significant factor that should be taken into account when discussing the prescribed opioid abuse is the demographics of users and the origin of the abused substance. According to the researchers, most nonmedical users obtain opioids through friends and family members, but the drugs themselves are purchased from legitimate prescriptions (Pon et al., 2015). These factors define the measures that should be – and are already – used in battling this issue.
Existing Strategy of Combating Prescribed Opioid Abuse
Acknowledging the scale and severity of the problem, the U.S. Department of Health and Human Services has developed a strategy on tackling the issue. There are five major priorities in this strategy: improving access to treatment and recovery services, promoting the use of overdose-reversing drugs, better public health surveillance, supporting research on pain and addiction, and advancing practices of pain management (National Institute on Drug Abuse, 2020, para. 4). These trends determine the specific measures taken to combat prescribed opioid abuse.
Thus, Centers for Disease Control and Prevention’s work focuses on monitoring trends, collecting and analyzing data, building state and local capacity by providing resources and support, and partnering with public safety officials and communities (Centers for Disease Control and Prevention, 2020). Moreover, a strong emphasis is put on collaboration with various authorities and organizations, including the Drug Enforcement Agency. Other specific measures include FDA recommendations on disposing of leftover medications, developing abuse-deterrent formulations to prevent manipulation of the opioid formulations, and prescription drug monitoring programs.
The recent statistics show that prescription opioid-involved death rates decreased by 13% (Centers for Disease Control and Prevention, 2020, para. 1). This allows to state that these measures are quite successful. However, there are further challenges that need to be faced to make the battle against prescribed opioid abuse even more effective.
Further Challenges in Combating Prescribed Opioid Abuse
The existing strategy of dealing with the problem of prescribed opioid abuse concerns different stakeholders and institutions. However, since it is health practitioners who prescribe the medicine, it is vital to emphasize this sphere. Several challenges should be taken into account when discussing the factor of physicians’ work.
The first challenge is the adoption of more effective strategies on the national level. They should be aligned with other actions included in prescription drug monitoring programs, be systemic and flexible enough to be adapted to particular circumstances. As pointed out by Barlas (2019) in his critique of the most recent SUPPORT legislation, it is crucial to ensure that the use of state-run databases would become mandatory for all the physicians and pharmacists. That would allow them to avoid issuing a prescription to someone with a risk of substance abuse.
Secondly, along with the introduction of systemic relevant policies, it is essential to provide health care practitioners with more precise and tangible support. As Volkow and McLellan (2016) mention, “many physicians admit that they are not confident about how to prescribe opioids safely, how to detect abuse or emerging addiction, or even how to discuss these issues with their parents” (p. 1253). Therefore, it is crucial to create conditions that would allow physicians to address these gaps in expertise and adjust their practice.
Finally, when battling the prescribed opioid abuse, one must remember that the need for opioids for many patients is real. According to Pon et al. (2015), “health care professionals must also remain vocal advocates for their patients with legitimate needs for opioids” (p. 677). Moreover, along with neglecting patients with chronic pains, practitioners must make sure that battling prescribed opioids would not turn substance abusers to other accessible alternatives.
Conclusion
Prescribed opioid abuse is a major large-scale problem that health authorities’ specialists have already given a name of “opioid epidemic”. The situation requires immediate measures and finding “a balance between flexibility and effectiveness” (World Health Organization, 2013, p. 25). However, many challenges should be tackled on the way. Among them are the systemic approach to the program, focus on education and support of health practitioners, and the right balance between prevention and prohibition of opioids.
References
Barlas S. (2019). Latest opioid abuse bill contains over 100 provisions but no far-reaching pharmacy mandates. Pharmacy & Therapeutics, 44(2), 29–63.
Centers for Disease Control and Prevention. (2020). Opioid overdose: Understanding the epidemic. Web.
Essack, Y., & Stanfliet, J. (2016). Opioid abuse. Professional Nursing Today, 20(4), 20-21. Web.
National Institute on Drug Abuse. (2020). Opioid overdose crisis.
Pon, D., Awuah, K., Curi, D., Okyere, E., & Stern, C. S. (2015). Combating an epidemic of prescription opioid abuse. CDA Journal, 43(11), 673-678. Web.
Volkow, N.D., & McLellan, A.T. (2016). Opioid abuse in chronic pain – misconceptions and mitigation strategies. The New England Journal of Medicine, 374(13), 1253-1263.
World Health Organization. (2013). Transforming and scaling up health professionals’ education and training.