Efforts to Combat Prescription Opioid Abuse

Prescription opioid abuse is now epidemic in our country. The statistics regarding addiction and death are staggering.

The rate of death due to overdose of prescription opioids more than quadrupled between 1999 and 2010. This far exceeds the combined death toll from cocaine and heroin overdoses. In 2010 alone, prescription opioids were involved in 16,651 overdose deaths, whereas heroin was implicated in 3036. A full 82% of the deaths due to prescription opioids and 92% of those due to heroin were classified as unintentional.

Rates of emergency department visits and substance use treatment admissions related to prescription opioids have also escalated dramatically. In 2007, prescription-opioid abuse cost insurers an estimated $72.5 billion – a substantial increase over previous years. Although these costs are similar to those associated with diseases such as asthma and HIV infection, a dramatically lower amount of health care dollars are spent to treat substance use disorders.

Responding to the prescription pill addiction epidemic, The Department of Health and Human Services (HHS) is implementing a widespread effort to address the key risks involved in prescription drug abuse, particularly opioid-related overdoses and deaths. This focuses on four main objectives: providing prescribers with the knowledge to improve their prescribing decisions and the ability to identify patients’ problems related to opioid abuse, reducing inappropriate access to opioids, increasing access to effective overdose treatment, and providing substance use treatment to persons addicted to opioids.

Basically, these objectives could be reduced to two words: knowledge and treatment. Physicians need increased education about opioids and heightened awareness about addiction. Prescriptions are written too flagrantly, far too often and with too little information about the patient’s substance use history. These dangerous and addictive drugs are simply too easy to obtain today.

For those with opioid addiction, we need a greater availability of treatment using evidence based therapies, including medication-assisted therapies (MATs) such as naltrexone and buprenorhine. When prescribed and monitored properly, MATs are safe, cost-effective, reduce risk of overdose and generally help patients recover. Yet, these drugs are underutilized due to barriers such as insurance coverage, too few qualified prescribers and negative attitudes and misunderstandings about medications among treatment professionals, recovering people, and lay people alike. Too many people continue to erroneously believe that MATs replace one addiction with another.

So, we return to the need for increased education. If physicians and the public alike had an improved understanding of substance use disorder, especially in the area of opiate addiction, patients would be helped rather than shamed. In place of lives continuing to be wrecked and lost by this disease (both addicts and their loved ones), we may see scores more added to the ranks of those who are saved, recovered and restored to health.

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