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The opioid crisis is a huge problem in the United States. The problem consists of a combination of doctors just prescribing narcotics to anyone who walks into the doctor’s office without properly verifying the patient’s condition through x-rays, medical documents etc. The opioid crisis has been going on since the 1990’s with over prescription of pain killers. A lot of pharmaceutical companies were prescribing stronger opioids as the solution to Americans physical pain management. Deaths from the opioid crisis has reach epic numbers with over 16,000 deaths. Just recently law makers passed a law ensuring stricter management of prescribing narcotics to people. The new laws implemented specific criteria and rules that doctors must adhere to. “The Institute of medicine estimates that chronic pain costs the U.S alone $560 to $635 billion a year in medical costs and lost productivity”. (Centers for Disease Control and Prevention (CDC). CDC grand rounds: prescription drug overdoses – a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012; 61:10–3) Every time a person overdoses it sends them to the hospital which increases medical costs and then we have the impact on the families, when a person dies from an overdose on either opioids or the synthetic drug fentanyl it tears families a part and when it involves parents who are drug addicts and the parents die from the over doses the children are then separated from their parents. Different from other drugs opioid abuse effects everyone. “16 percent of people interviewed knew someone who overdosed on opioids”. The disease for center control agrees that the epidemic is fueled by the over prescription of opioids for pain relief. Lack of guidelines and with prescribing of opioids is a factor in people in over dosing on these pain killers. (. Centers for Disease Control and Prevention (CDC). CDC grand rounds: prescription drug overdoses – a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61:10–3) The opioid epidemic will continue to be a challenge that will not easily be fixed. (Vadivelu, Nalini, et al. “The Opioid Crisis: A Comprehensive Overview.” Current Pain and Headache Reports, vol. 22, no. 3, 2018, pp. 1-6.) “More recently researchers have come across a disturbing trend now pregnancy and opioid use. Recent cases have seen woman of reproductive age has steadily been climbing between 2008 and 2012”. (Vadivelu, Nalini, et al. “The Opioid Crisis: A Comprehensive Overview.” Current Pain and Headache Reports, vol. 22, no. 3, 2018, pp. 1-6.)

When we look at opioids what are they actually? An opioid is a compound that resembles opium. “It is in a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescriptions, such as oxycodone, hydrocodone, codeine, and morphine”.( www.drugabuse.gov › Drugs of Abuse) Let’s look at the opioid crisis and why the opioid epidemic started. In the 1990’s there were a surge of over prescribing of opioids by doctors leading many people to become depended on the opioid drugs such as Hydrocodone or Oxycodone. This crisis more prevalent in the Mid-west, after people were so hooked on opioids and they couldn’t get more refills they started using Fentanyl a potent synthetic opioid. “It considered a national crisis with 42,000 lives lost in 2015 to opioid abuse. Some of the state findings found Indiana sustained $43 billion in economic damages to date spanning 2003-20017 with an additional $4 billion in 2018. Indiana had 12,300 residents who died from over doses to opioid abuse.” (Introduction: The opioid crisis. (2018). Indiana Business Review, 93(1), 1-3.) For about thirty years the Pain Medicine practitioners were concerned about the potential for their patients to develop an independence on opioids and as a result has left opioid therapy a largely underutilized treatment. They said while there is no simple answer to chronic pain, opioids remain the only class of drugs capable of providing relief to patients with chronic pain. (Smith, Howard S.. Opioid Therapy in the 21st Century. Cary: Oxford University Press, Incorporated, 2008. Accessed September 16, 2018. ProQuest Ebook Central.) “The breakdown of what ethnic backgrounds are abusing opioids are as follows 80% are males living in urban areas, 90% are Caucasian.” (Vadivelu, Nalini, et al. “The Opioid Crisis: A Comprehensive Overview.” Current Pain and Headache Reports, vol. 22, no. 3, 2018, pp. 1-6.)

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There is much debate on how to address the opioid crisis, better education is needed with doctors with safer means of prescribing of opioids. In the journal article (Vadivelu, Nalini, et al. “The Opioid Crisis: A Comprehensive Overview.”) They contribute at least partly the epidemic to poor management with which Oncologists, primary care physicians, dentists, surgeons, and emergency room physicians, direct opioid therapy. Doctors have a habit of prescribing opioids to patients who come in to see them and for some of these patients the patients tell the doctor their symptoms, their pain and what the doctor should prescribe them which should be a red flag that these patients are pill seekers. It is not only the responsible of the state to educate doctors and medical providers on proper methods of prescribing opioids, but it is the responsibility of our education system to educate our young generation on the effects of pain killers such as Hydrocodone and oxycodone and how deadly they can be when abused. Addressing the opioid crisis can also be accomplished through proposed regulation on stiffer rules for the prescribing of opioids. New legislation is being worked on that will propose for new patients seeking opioid pain killers will only be only prescribe a seven-day supply then the patient will have to be reevaluated by the doctor to be prescribed more. Legislation also is being introduced in the United States which is already being implemented in the state of Florida effective October 31st that doctors who are going to be prescribing opioids must adhere to new training such as register with the Federal Drug Enforcement Agency, complete a two to three hour course on prescribing, register under their medical license that they treat chronic pain, document the patients pain and make a plan for treating the patient pain, check the state database to see whether there are other narcotic/ opioid prescriptions for the patient. (How Florida’s new opioid-prescription law affects you Marylin Mayer The Lakeland Ledger) Among other education states are suggesting is patient education on opioids, a lot of patients don’t have or know a clear understanding of most of the medications that they are taking and unfortunately that lack of knowledge contributes to patients abusing and misuse of prescriptions with attention to opioids. With the younger generation researchers followed were following over 2,000 middle school and high school who were prescribe opioids for medical use and found they were not using them as prescribed or became addicted to other drugs that started from opioid use. (Aurelien, Joanne, et al. “Patient Opioid Education: Research shows Nurses’ Knowledge of Opioids Makes a Difference.” MedSurg Nursing, vol. 25, no. 5, 2016, pp. 307.)

Canada has proposed that they install vending machine throughout the country that would for a small price dispense opioids so that people would not try to buy Fentanyl. But Canadians and Americans alike agree that doctors should seek alternative methods of treatment such as all-natural products. Different states have their own responses they are using to curve the epidemic. All 50 states operate prescription drug monitoring programs as well as covering buprenorphine treatment under their Medicaid programs. All 50 states passed naloxone access laws as well as needle exchange programs. Like Florida half of the states have limited the number of opioid pills that patients are dispensed. Part of the movement with the states is to publicize the unnecessary prescription dispenses such as giving a 30-day supply to a patient for wisdom teeth removal. Another state Massachusetts became the first state in 2016 to limit the amount prescribe. The state set a seven-day policy for new opioid prescription which Florida has followed in 2018. Certain pharmacies like the CVS chain have adopted this plan to combat opioid abuse. ( Parker, Andrew M., Daniel Strunk, and David A. Fiellin. “State Responses to the Opioid Crisis.” The Journal of Law, Medicine & Ethics, vol. 46, no. 2, 2018, pp. 367-381.) Recently researchers at the Walter Reed Army institute are experimenting with a vaccine that will help people overcome their addiction to opioids. (https://www.sciencedaily.com/releases/2017/)

In conclusion opioids are highly addictive pain killers that started in the 1990’s. These narcotics have led to the deaths of over 90 Americas a day, to address this issue better education is needed not only for the doctors who prescribe opioids but for the younger generation still in high school and college, so the effects of opioids are better understood as well as the consequences of abusing opioids. Proposed regulations on opioids is in the works for many states even though some states like Massachusetts has already implemented policies that limit the number of opioids that a patient can receive. For new patients seeking a new prescription for opioids they will only receive a 7-day supply of the opioid and will be required to have a follow up with the doctor to receive anymore opioids. The opioid crisis will continue to get worse if doctors are prescribing opioids such as hydrocodone or oxycodone without thoroughly knowing the medical back ground of the patient. For a patient with a chronic pain such as knee, back or neck or some other crippling injury they make the exception for being able to be prescribed opiates on a regular basis. With more pain management being implemented and all-natural medicines we might be able to curve the epidemic that has been claiming more and more lives each day.

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