Sample Healthcare Essays on The Opioid Epidemic

In the past decade, there has been increases in the reports made on the usage of opioids in the United States and Canada. The aging population coupled with other factors such as the existence of numerous chronic illnesses that places patients at risk of suffering from chronic pain contributed to high rates of opioid use within the country. Concerns related to opioids use are usually based on the addictive effects of these drugs. While some healthcare provider prescribe them for pain management, their use still raises questions on whether their benefits outweighs their addictive effects on patients.

The opioid use disorder (OUD) crisis is described as the second most devastating health epidemic to be faced by the United States since HIV/AIDS (Bonnie, Ford & Phillips, 2017). The increased use of opioids has led to the rise of opioid addiction and related morbidity and mortality. The USA reports approximately 130 deaths of patients daily occurring from an overdose of opioid prescriptions (Verhamme & Bohnen, 2019). According to the Bipartisan Policy Center (2019), there are three major phases of the opioid epidemic described by the CDC starting with deaths from overuse of prescription opioids, increasing the use of heroin due to difficult access of opioid prescription and lastly the use of synthetic opioids or fentanyl originating from China.

The effects of the opioid epidemic are being felt across every socio-demographic group in the USA, but the burden is heavier for the vulnerable groups from low social-economic class in the country (Bonnie, Ford & Phillips, 2017). The root causes of opioid drug addiction include factors such as the wide existence of clinics and pharmacies that irresponsibly dispense opioids, many published reports advocating the opioids safety, and the public attitudes on how to manage pain leading to an  overreliance on opioid  (Verhamme & Bohnen, 2019). The mortality rate related to opioid overdose occurs mostly among the population of below 50 years. In Massachusetts for instance, deaths are high in men aged 18 34 years than women of the same age, especially among people released from prison who suffer from social isolation, low tolerance rate and high relapse (Bonnie, Ford & Phillips, 2017). These groups easily acquired opioid prescriptions from the clinics and pharmacies. People who misuse opioid prescriptions are at high risk of other substance abuse disorders. About 80% of users of heroin injectable in the United States began their addiction from opioid prescriptions (Oesterle, Thusius, Rummans & Gold, 2019).

Following the devastating epidemic of opioid use, finances are being directed to the management of this crisis by the USA federal government. The government under the 21st Century Cures Act has invested billions of money in financing the prevention, treatment and recovery efforts of patients with an opioid disorder. The funding is also directed on initiatives to reduce the supply of unnecessary prescriptions and illicit opioids (Bipartisan Policy Center, 2019). One of the pros of the government-funding program is financing the treatment of people with opioid disorders that are uninsured, bridging the gap between those seeking treatment and those receiving it. Besides, the funding is also provided to finance the training on more physicians who can work in buprenorphine clinic settings for the treatment of opioid patients (Kansagra & Cohen, 2018).

Despite financial investment by the government, the opioid epidemic is yet to be managed. Use of government funds to manage this crisis is taking a toll on the USA economy with an estimated financial burden of 631 billion dollars between 2015- 2018 (Staff, 2019). Nearly one third of the USA economic burden has been attributed to excessive healthcare expenditure on patients diagnosed with opioid addiction disorder, and infants born with the neonatal withdrawal syndrome due to use of opioid by pregnant women. Funding for various surveillance systems on drug use has been cut short over the years resulting to a challenge on available data on the effect opioid use on public health

Medical interventions have been introduced to prevent and manage the opioid addictions to curb the opioid epidemic. Health service providers can use the Opioid Misuse Measure as a preventive tool to identify people using opioids under long-term pain therapy who may exhibit the behavior of opioid misuse (Oesterle, Thusius, Rummans & Gold, 2019). After conducting screening for opioid use disorder, the medical practitioners conduct brief interventions and referrals for treatment. There are three approved medications by the Food and Drug Administration (FDA) for treatment of OUD namely methadone, buprenorphine and naltrexone (Bonnie, Ford & Phillips, 2017).  Each of the medications has pros and cons.

Naltrexone was developed in 1965. It acts as a blocking agent rather than an activating agent for the treatment of opioid use disorders (Bonnie, Ford & Phillips, 2017). The pros of this medication are that it has greater potency, longer duration of action making it ideal as a blocking agent for the treatment of opioid patients. Another medical benefit is that it decreases overdose and boosts chances of becoming sober. Naltrexone does not contain a potential for abuse and has no street value, which decreases dependence. One major con of naltrexone is that it can increase liver enzymes. Patients also have to take the medication regularly to see results (Oesterle, Thusius, Rummans & Gold, 2019).

Buprenorphine is a medication for the opioid disorder, which acts both as a blocker and as stimulator of the µ opioid receptor.  This pros buprenorphine is that it promotes sobriety, reduces instances of overdoses, and reduces criminal activity, making it very effective in OUD treatment. One con of buprenorphine use is that it has a potential of abuse for opioid patients. The USA has reported about 49% of illegal cases of opioid use among patients who mostly use it to relive opioid withdrawal (Oesterle, Thusius, Rummans & Gold, 2019). Another con is that treatment is long term and there is no definite period for the use of Buprenorphine.

Methadone was an opioid agonist approved in 1974 for opioid addiction treatment under strict surveillance. The pros of methadone are the reduction of death rates from overdose reduces the illegal use of opioids and promotes health and social productivity in patients. One major disadvantage is that methadone agonist property increases its risk of abuse and accidental overdoses compared to the buprenorphine and naltrexone (Oesterle, Thusius, Rummans & Gold, 2019). Treatment of opioid addicts in controlled clinics has been safe and has reduced the illegal use of the medication.

The public opinion polls indicate that Americans have differing sentiments regarding how to address the opioid use epidemic. Despite the government’s attention in addressing the crisis, only 20% of the public feels that enough progress is being made in addressing the opioid epidemic. Others feel that abuse of opioid is a national emergency in the country (Cook & Worcman, 2019). While some public sentiments point out that the country is headed in the wrong direction in managing the opioid epidemic, the amount of public support needs to be considered. The opinion of the public in the USA has implications on policies regarding the opioid epidemic. The government should put into consideration public sentiments when deciding on the appropriate treatment policies that will gather public support. Currently, most Americans are supporting the treatment of opioid addicts through pragmatic methods of community-based interventions as opposed to punitive policies that punish opioid users (Cook & Worcman, 2019). The public sentiments benefit both the public and the government in the fight against the opioid addictions.

The pros of reliance on public opinion, which advocates the use of community-based services are essential in increasing the recovery process of people with opioid use disorder. The patients have shown a reduction in criminal behavior, boosting their social and family functioning and reducing substance abuse and giving them a chance for employment. This method advocated by the public is less costly to the government compared to treatment in the emergency hospital rooms. The disadvantage is that the public sentiments indicating that opioid is not a national epidemic may affect the government efforts to fight and reduce the crisis in the country (Cook & Worcman, 2019).

The opioid epidemic is likely to increase in the next decade especially due to more use of illicit opioids across various states. A more preventive measure of restricting the exposure to prescriptions of opioid medication is required to curb this crisis. The state and the local governments need to adopt long-term approaches to manage the crisis. Multiple strategies including flexible funding methods, partnerships, and coordination with all relevant stakeholders including healthcare, law enforcement institutions, academic sectors, funding institutions, philanthropists and policymakers, and the public are needed to curtail the rising opioid epidemic in the USA.

 

References

Bipartisan Policy Center. (2019). Tracking federal funding to combat the opioid crisis. Washington, DC: Author

Bonnie, R. J., Ford, M. A., Phillips, J. (2017). Pain management and the opioid epidemic: Balancing societal and individual benefits and risks of prescription opioid use. Washington, DC: The National Academies Press.

Cook, A.K, & Worcman, N. (2019). Confronting the opioid epidemic: public opinion toward the expansion of treatment services in Virginia. PubMed Central, 7(13). doi: 10.1186/s40352-019-0095-8

Kansagra, S. M., & Cohen, M.K. (2018). The opioid epidemic in NC: Progress, challenges, and opportunities. North Carolina Medical Journal, 79(3), 157-162

Oesterle, T.S., Thusius, N. J., Rummans, T.A., & Gold, M.S. (2019). Medication-assisted treatment for opioid-use disorder. Mayo Clinic Proceedings, 94(10), 2072-2086. doi: https://doi.org/10.1016/j.mayocp.2019.03.029

Verhamme, K.M.C., & Bohnen, A. M. (2019). Are we facing an opioid crisis in Europe? The Lancet Public Health, 4(10), 483-483. doi: http://dx.doi.org/10.1016/ S2468-2667(19)30156-2