Opioid medication has been a reliable method of pain treatment for centuries. Long-term opioid use has the potential to have substantial side effects, including addiction, and cognitive impairments, in addition to the “typical” opioid-induced adverse effects (such as constipation and cognitive deficiencies) (Hjsted et al., 2013). Opioid Use Disorder (OUD) involving prescription opioids affects at least 2 million people, and OUD involving heroin affects about 600,000 (Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse et al., 2017). In order to emphasize the opioid addiction epidemic inside the US healthcare system and propose potential ways to mitigate its detrimental consequences on society, this study seeks to analyze and summarize Stoicea et al. (2019). This essay will examine the summary of findings from the cited article, list the study’s benefits, and debate if it will help address the opioid addiction issue.
Incidence and Prevalence of Opioid addiction
Overprescribing, illegally distributing, and misusing opioids have become widespread in the US during the past 25 years, leading to rising evidence of opioid prescription drug addiction and dependence disorders, non-medical use of pharmaceutical opioids, and rates of accidental overdose deaths (Stoicea et al., 2019). In the US, 6% of people (15–64 years old) admitted to abusing opioids in some way, and 115 Americans are thought to have died from opioid overdoses every day in 2015 (Theisen et al., 2018).
Aim of the study
Stoicea et al. (2019) reviewed recent research on those responsible for the opioid abuse crisis and examined any possible links between demographics (race, culture, gender, and religion) and opioid abuse, overdose, and accessibility.
Research Method and Design
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) standards, the authors conducted a thorough literature search in the Google Scholar and Pub Med databases for articles published between December 7, 1999, and January 9, 2018. Medical subject headings (MeSH) such as “opioids,” “over-prescription,” “opioid consumption,” or “opioid epidemic” were used as search references. Additionally, two authors independently screened the search results for eligibility. They assessed the relevant papers to see if they were: focused on the US population, published in English, and relevant to the epidemic of prescription opioids or other illicit opioid misuse.
Sample Size and Description
Only 70 papers were chosen as credible full-texts addressing a range of contributing variables surrounding the opioid crisis out of 120 manuscripts that underwent eligibility selection. The authors discovered 12 articles providing information from a significant number of patients among these 70 publications.
Overview of Findings
Stoicea et al. (2019) identified several related factors directly or indirectly related to the current opioid abuse crisis in the United States. Among these factors include; demographics, shifting patterns from prescription opioids and heroin abuse, over-prescription, and “Doctor shopping.”
Demographics and US regional distribution
According to the National Center for Health Statistics, non-Hispanic whites experienced the most devastating increase in mortality, with adults ages 45 to 54 suffering the highest mortality rates. According to the study, men are more likely than women to test positive for substance use disorder (SUD), including opioid use disorder (OUD) (77% vs. 44%).
Shifting patterns from prescription opioids
Hydrocodone, oxycodone, and morphine are the most commonly prescribed opioids in the United States (Han et al., 2017). The general public’s easy access to prescription opioids has shifted addiction trends by introducing consumers to other opioid drugs, such as heroin and other illegal opioid formulations, exacerbating the problem by creating an interaction between the two.
Over-prescription
Over-prescription by practitioners is one of the leading causes of addiction. Hydrocodone and oxycodone prescriptions have increased from 76 million in 1991 to approximately 207 million in 2013. Consequently, approximately 25% of patients prescribed opioids by medical practitioners display characteristics of recreational use.
“Doctor shopping”
Another common method of obtaining opioids is “doctor shopping,” which involves visiting multiple providers to obtain a surplus of medication (Compton et al., 2015)
Strengths of the study
The study effectively articulated how current literature on opioid misuse confirms incidence, associated factors, and potential approaches to opioid addiction treatment. Furthermore, to meet eligibility criteria, the study screened out articles from their database search, such as abstract publications, resulting in more relevant information on the trends of the opioid addiction crisis.
Discussion
Considering the high relapse rates among opioid-dependent patients, recovery treatment strategies such as positive religious coping, reducing opioid consumption, and increasing participation in related programs have been useful. On the other hand, new prescription drug-monitoring programs (PDMPs) have been developed in response to “doctor shopping” to curb this exploitation. These programs provide physicians with an electronic database containing each patient’s prescription history, which can be checked prior to and after a new prescription is written.
Conclusion
The widespread use of opioids and the epidemiology of the problem in the United States have been thoroughly researched. However, alternative forms of therapy have emerged due to a lack of solutions for the rising number of overdose deaths. Clinical education for healthcare practitioners, consumers, and at-risk individuals are one of the most effective ways to combat the opioid crisis. A three-point approach emphasizing prevention, treatment, and rehabilitation for those currently affected and at risk in the future, may be the most comprehensive solution. This may include a multimodal approach to treatment that prioritizes patients based on their risk level.
References
Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse, Board on Health Sciences Policy, Health and Medicine Division, & National Academies of Sciences, Engineering, and Medicine. (2017). Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use (R. J. Bonnie, M. A. Ford, & J. K. Phillips, Eds.; p. 24781). National Academies Press. https://doi.org/10.17226/24781
Compton, W. M., Boyle, M., & Wargo, E. (2015). Prescription opioid abuse: Problems and responses. Preventive Medicine, 80, 5–9.
Han, B., Compton, W. M., Blanco, C., Crane, E., Lee, J., & Jones, C. M. (2017). Prescription opioid use, misuse, and use disorders in US adults: 2015 National Survey on Drug Use and Health. Annals of Internal Medicine, 167(5), 293–301.
Hjsted, J., Ekholm, O., Kurita, G. P., Juel, K., & Sjgren, P. (2013). Addictive behaviors related to opioid use for chronic pain: A population-based study. Pain, 154(12), 2677–2683. https://doi.org/10.1016/j.pain.2013.07.046
Stoicea, N., Costa, A., Periel, L., Uribe, A., Weaver, T., & Bergese, S. D. (2019). Current perspectives on the opioid crisis in the US healthcare system: A comprehensive literature review. Medicine, 98(20), e15425. https://doi.org/10.1097/MD.0000000000015425
Theisen, K., Jacobs, B., Macleod, L., & Davies, B. (2018). The United States opioid epidemic: A review of the surgeon’s contribution to it and health policy initiatives. BJU International, 122(5), 754–759.
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