Opioid have been used in several years as painkillers in the US. The popularity of using opioid started in the early 1990s. However, its uses have significantly increased from then. The increasing use of opioid among the Americans has become a major public health problem just like the substance use disorder. Abraham et al. explained that the deaths related to the overdose of opioid in America in the last 15 years have increased by more than 200% with more than 12 million people reporting misuse of opioid pain killers in 2015 (31). Various initiatives have been put in place in the past three decades to address the abuse and addiction of opioid at the local, state and federal levels. The efforts are also meant to reduce the number of deaths related to opioid use in America. The primary focus of these initiatives is primary prevention as well as providing access to treatment, although there has been a significant growth in the number of harm reduction programs over the past decade. Murthy explained that the opioid initiative started in 2015 by the state department of health and human services are aimed at improving the prescribing practices, expansion of naloxone distribution, and increasing access to medication-assisted treatment (387). Although prevention is seen as the most practical way of addressing the opioid epidemic, treatment, as well as harm reduction initiatives, should be given more consideration because of their proven efficacy as well as cost-effectiveness.
As the use of opioid among the US population increases beyond the medical purpose as a painkiller, the nation continues to record increased number of deaths related to its abuse. Also, more people using opioid suffer opioid related disorders. There are several strategies for addressing the problem of opioid use and abuse. Primary interventions mainly focus on reducing the chronic as well as acute pain in patients, opioid pharmacotherapy, or engaging the users through educational intervention initiatives to avert abuse. Educational intervention strategies usually target people who are at a higher risk of abusing opioid, or individuals who are close to at-risk people and they stress the importance of locking up their medications or not sharing their prescribed medication with others. It also emphasizes on good ways of disposing of surplus medications (Hawk et al. 237). Despite the increasing popularity of educational interventions, their impact on substance users is unknown. The healthcare professionals have used other interventions such as the prescription monitoring programs, but their effectiveness in identifying those individuals having disorders associated with the use of the opioid is yet to be established (Hawk et al. 238).
On the state level, the efforts made in reducing the number of new opioid users including increasing the access to the opioid therapist as well as the optimization of opioid prescription have yet to be successful. As noted by Meldrum, notes that despite a multidisciplinary approach being the best available alternative to opioids, third parties often consider it too costly (1365). Given that most physicians are unable to diagnose, monitor adequately, and manage enduring pain conditions, such mono-therapeutic strategy becomes the only alternative which increases the number of opioid users (Chapman 5). Also, the recent restrictions that prohibit clinicians from issuing opioid prescription via phone calls have worsened the situation since doctors would favor giving a one-off prescription of several drugs to help the patient just in case of an emergency. Even though the new prescribing guidelines provided by the CDC provides an excellent strategy for curbing abuse of opioids, it will take several years for the medical practitioners to adopt it fully.
Unlike the most recent initiatives aimed at preventing the use of opioid, treatment strategies for disorders associated with opioid have existed for many decades and extensive research supports their use. Research suggests that medication assisted treatment for opioid disorders can reduce the criminal behavior while at the same time reducing the deaths related to overdose and all-cause of use of opioid. The Food and Drug Administration (FDA) has approved naltrexone, methadone, and buprenorphine as the recommended medicine for treating opioid related disorders. These three drugs can successfully treat the acute phase as well as the chronic phases of opioid use disorder. Murthy reported that the US Office of the Surgeon General is making efforts to change the American public from thinking negatively about the substance use addiction or disorders but rather see it as a chronic illness that can be treated with skill, urgency, and compassion (388). Also, the government’s commitment to ensuring that people suffering from opioid related disorders get the necessary treatment was emphasized by the $1 billion investment that was allocated by the president for the fiscal year 2017 (Murthy 387).
Another approach makes use of the techniques that have been proved to be successful in the treatment of patients with alcohol dependence. This approach includes a structured discussion with the individuals affected reflecting on the substance use as well as its negative consequences, developing a recovery plan and focusing on the ways of modifying the patients’ behaviors (Hawk 238). Hawk further explains that a recent randomized controlled trial showed that there was a significant increase in the treatment engagement as well as a significant decrease in the use of opioid after the treatment following the referral by an emergency department physician (238). This further shows the increasing trend of destigmatizing drug and substance abuse since the medical practitioners treat their patients with dignity just as they treat patients suffering from other chronic illnesses such as asthma, hypertension, or diabetes (Hawk 238).
Although prevention is viewed as an automatic logical method of combatting the US’ opioid use crisis, treatment, as well as harm reduction, have been more cost-effective as well as efficient strategies that target at-risk people. Destigmatizing the use of substance abuse and focusing on the reduction of its detrimental consequences has proved to be one of the major components of the treatment of opioid use disorders. From an economic point of view, investing in the treatment of addiction has the potential to eliminate the medical and financial costs as well as the social consequences that come later.
- Abraham, Amanda J. et al. “The Affordable Care Act Transformation of Substance Use Disorder Treatment.” American Journal of Public Health, vol, 107, no. 1, 2017, pp. 31–32.
- Chapman, C. Richard. “Opioid Pharmacotherapy for Chronic Noncancer Pain: The American Experience.” The Korean Journal of Pain, vol. 26, no. 1, 2013, pp. 3–13.
- Hawk, Kathryn F., Federico E. Vaca, and Gail D’Onofrio. “Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies .” The Yale Journal of Biology and Medicine, vol. 88, no. 3, 2015, pp. 235–245.
- Murthy, Vivek H. “A Promise Fulfilled — Addressing the Nation’s Opioid Crisis Collectively.” Public Health Reports, vol. 131, no. 3, 2016, pp. 387–388.
