Finding a Solution to the Opioid Crisis
The current opioid crisis affecting the American population has been widely attributed to overprescription by physicians. While this theory represents a part of the epidemic, policies that solely address this facet of the problem ignore the many underlying factors that drive individuals to addiction and overdose. To reverse the current state of drug abuse, it is necessary to understand the influence of socioeconomic factors. The solution is not as simple as access regulation, as the growing dependence on opioid products transcends the role of the health care provider and highlights a larger societal issue that drives individuals to this form of self-medication. In efforts to address this problem, the American Journal of Public Health (AJPH) posits that there are three predominant phases to the overdose epidemic that span the past 40 years.
In the 1980s, reliance on opioids to treat acute pain had risen to the point that misuse of these legal drugs resulted in 70% of drug related injury or deaths. A decade later, the nation witnessed a shift in policy and medical practices as treatment for chronic pain transitioned from primarily cognitive behavioral therapy to prescription of opioid painkillers. The lack of coverage for behavioral therapy paved the way for pharmaceutical companies to transform chronic pain into a business by the 2000s. This escalation in opioid products marked the first phase of the opioid crisis. The second phase began with an expanded dependence on prescription opioids combined with heroin abuse. A spike in fatal cases of heroin overdose was observed as users sought a cheaper and stronger substitute to prescription drugs. Although the use of opioid analgesics in the health care setting was under scrutiny at this time, the manufacture of cheaper drugs such as fentanyl at the global level led to a public health emergency by 2013 as death rates rose.
In the 1980s, reliance on opioids to treat acute pain had risen to the point that misuse of these legal drugs resulted in 70% of drug related injury or deaths. A decade later, the nation witnessed a shift in policy and medical practices as treatment for chronic pain transitioned from primarily cognitive behavioral therapy to prescription of opioid painkillers. The lack of coverage for behavioral therapy paved the way for pharmaceutical companies to transform chronic pain into a business by the 2000s. This escalation in opioid products marked the first phase of the opioid crisis. The second phase began with an expanded dependence on prescription opioids combined with heroin abuse. A spike in fatal cases of heroin overdose was observed as users sought a cheaper and stronger substitute to prescription drugs. Although the use of opioid analgesics in the health care setting was under scrutiny at this time, the manufacture of cheaper drugs such as fentanyl at the global level led to a public health emergency by 2013 as death rates rose.
The opioid epidemic most severely hurts communities living in poverty. Poverty increases risk of decreased mental and physical well-being which can result in dependency on medications containing opioids.
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Although the rise in availability of such drugs has contributed to the epidemic, the demand for such substances lies in the social factors in an individual's life that enable drug addiction. Poverty is a major determinant of drug abuse, for this often means unsafe work conditions and inadequate environmental conditions resulting in health issues or injuries that are treated with medications containing opioids. Current efforts to curtail the overdose crisis involve regulation of dosage, though the determining factors elucidate the need for a more comprehensive approach that takes into account the situations that leave individuals vulnerable in the first place.
The misuse of analgesics is an issue deeply ingrained in the structure of our society. Potential solutions that target the clinical aspect of the crisis do little to undo the decades of opioid misuse. There needs to be a shift in focus from the drug supply to the reasons why people turn to these medicines in the first place. For there to be progress, health care providers need to incorporate a comprehensive public health approach that takes into account the years of social and economic determinants that contribute to addiction.
The misuse of analgesics is an issue deeply ingrained in the structure of our society. Potential solutions that target the clinical aspect of the crisis do little to undo the decades of opioid misuse. There needs to be a shift in focus from the drug supply to the reasons why people turn to these medicines in the first place. For there to be progress, health care providers need to incorporate a comprehensive public health approach that takes into account the years of social and economic determinants that contribute to addiction.
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