As National Recovery Month quickly comes to a close it is important to talk, once again, about opioid use disorders. The use of which has resulted in the most serious addiction epidemic to ever bear down on the United States. Naturally, being in the field of addiction medicine, we’ve covered this topic at great length. From causation to consequence. While we can talk about such things ad nauseam, it is far more important to discuss some ways out this “perfect storm.”
In the immortal words of Robert Frost, “the best way out is always through.” So, and with that logic in mind — headfirst into the storm, we go. As has been pointed out, time and time again, the root of the epidemic rests with opioid prescribing practice standards. Which, up into recently, there were relatively few. But, even with greater utilization of prescription drug monitoring programs (PDMPs) opioids are still prescribed in great numbers. In fact, in many California counties, there more prescription opioids than people, according to the California Department of Public Health.
Case in Point: 2016 Trinity County population — 13,628 people. However, there were 18,439 prescriptions filled in the same year. The highest per capita rate of opioid prescriptions in California, in the fourth smallest county in the state.
The case of Trinity County is not unique to rural California, any more than it is to rural America. Prescription opioids may be a little harder to get or prescribed in large numbers. But, it has had very little effect overall. After all, more people died of overdoses in 2016 than 2015. The only real and notable difference is what people are overdosing on, and why.
Preventing New Opioid Use Disorders
Fewer people are dying from prescription opioids than just a few years, ago. Which is great. However, more people are dying from heroin and fentanyl, an even deadlier opioid analgesic. A New York Times analysis found that 15,400 overdose deaths could be attributed to heroin, 20,100 to fentanyl. The Centers for Disease Control and Prevention (CDC) indicates that 64,000 Americans died of drug overdoses during last year. Which means that more people are dying from illicit opioids than prescriptions.
Such numbers should not be read to mean that the focus of addiction prevention should pivot to illicit opioids. Especially when you consider that most people report starting down the path to opioid use disorder with prescription painkillers. The heroin and fentanyl problem in America has its origins in prescription opioids. And opioid use initiation most commonly begins with a prescription, still. The Trinity statistics are a clear indication that the business of prescribing is, good.
There is no question, making headway requires a multifaceted approach. Calling upon both lawmakers to enact common sense legislation and health leaders to push for more informed doctors. The better doctors understand addiction, the fewer patients who will be prescribed opioids. In turn, reducing the number of future opioid use disorders. What’s more, encouraging doctors to only rely on a prescription opioid when it’s absolutely necessary.
In the United States we’ve become so reliant on opioids, we ignore the alternatives. Non-opioid methods of managing pain, that in many cases can be more effective, and certainly less dangerous.
Opioid Addiction Can Be Avoided
Every time opioids are prescribed, there is potential for future opioid use disorders. You may be surprised to learn that with some forms of pain, opioids can exacerbate one’s symptoms. If “addictive” and “prolonging pain” is a possibility, it dictates that doctors should look elsewhere in many cases. You’d even think that doctors would welcome opioid alternatives, and in many cases, they do. But, there are still others who rely heavily on prescription opioids for all things pain. Despite the risk of opioid use disorders. The reason for this is often because of financial incentives to prescribe certain drugs by the pharmaceutical and insurance industry.
Apropos to this, attorneys general (AG) from 35 states sent a message to insurers encouraging painkiller alternatives, The Los Angeles Times reports. Addressed to the trade group America's Health Insurance Plans, the letter called for insurers to prioritize coverage of non-opioid treatments. As wells as, pain management techniques that include physical therapy and massage.
If we can get the best practices changed with insurance companies and the payment incentives are just a bit different than what they are today, I think that's going to continue to see the number of pills prescribed and dispensed drop dramatically," said West Virginia Attorney General Patrick Morrisey. "This is an important new front to open up."
Reducing prescriptions is just one step in reducing the prevalence of opioid use disorders, but it’s perhaps the most salient. With more than 2 million with opioid use disorders and rising, action is required now. Both the pharmaceutical and insurance industry can have a major role in ending an epidemic they helped create.
Opioid Use Disorder Treatment
Efforts to change prescribing practices are vital, but they don’t mean much to those already in the grips of addiction. Equally important to reducing our reliance on opioids, is increasing our reliance on addiction treatment. Tempering the storm of opioid addiction is best achieved through opioid use disorder treatment. Recovery is possible, and if you have been touched by the disease, please do not hesitate to reach out for assistance. At PACE Recovery Center, we are fully equipped to assist young men who are ready to break the insidious cycle of addiction. Please contact us today, and make this Recovery Month the beginning of your own recovery.