Outlawing Opioids. What are some strategies to end the opioid epidemic once and for all?

Overdose Deaths Continue Due To The Current Opioid Crisis

There is much debate over how the opioid crisis began. Many theories state that when doctors prescribe an opiate or opioid for pain, they contribute to the problem because of the high risk of patients becoming addicted to the opioid medication. Over many years of oxycodone and hydrocodone prescribing for chronic pain, doctors have created a major crisis in our country. At least, that is how the story is often told.

The opioid epidemic is a heroin and fentanyl problem.

However the crisis unfolded, there is no doubt that the current problem is related to street opioids. Heroin is the foundation of the crisis and fentanyl is the cause of many opioid overdoses and opioid deaths. The problem is that heroin is no longer just heroin. When drug users buy heroin on the streets, they are, in most cases getting fentanyl. Fentanyl is a super-potent synthetic opioid that is 80-100 times more potent than morphine. In fact, when drug users buy prescription pills on the streets, like oxycodone, hydrocodone (Vicodin), OxyContin, or Dilaudid, they may be getting fentanyl. Common opioid tablets are now being manufactured in clandestine laboratories to look just like the real thing but are actually made up of fentanyl.

The path from Demerol to heroin.

Demerol is a semi-synthetic opioid that is most often administered by injection. It is not used as often as it used to be. In recent decades, Demerol was used frequently in minor outpatient procedures, such as colonoscopies and minor surgeries. We know now that the risk of becoming addicted to opioids may be higher than previously thought. And, it is possible that such a powerful opioid was not needed in many of these procedures. A person who became addicted to opioids after being given an opiate shot may eventually find themselves addicted to heroin. Usually, the drug abuse victim moves from one opioid to another until, one day, a dealer offers them heroin. Heroin is a close relative of morphine, a legal opioid. It is not hard for a drug user to justify the move to heroin use. 

Codeine and other prescription opioids.

Codeine is another opioid that is closely related to morphine. However, codeine is considered to be a relatively mild opioid. Because codeine causes constipation at relatively low doses, it is rarely abused at the level that other drugs are abused. In fact, codeine used to be available in cough syrups that did not even require a doctor’s prescription.

Purdue Pharma and OxyContin

Doctors get much of the blame for initiating the opioid epidemic by overprescribing opioid analgesics for pain instead of relying more on non-opioid solutions. Another source of blame is Purdue Pharma and the Sackler Family. The Sacklers were behind the release of OxyContin, a long-acting form of oxycodone. Oxycodone is a semi-synthetic opioid that has a high potential for abuse. OxyContin is an extended-release tablet that contains large amounts of oxycodone. Many people believe that Purdue had the intent to sell as much OxyContin as possible, regardless of the consequences.

Opiate addiction, dependence and opioid overdose.

When a person takes too much of an opiate, they are at risk for respiratory depression. This is the cause of opioid-related overdose. Breathing slows down and even stops. people who are addicted to an opiate are at high risk for overdose. If naloxone is available, it can reverse the respiratory depression and stop the overdose. Naloxone is a drug that blocks the opioid receptor and causes opioid withdrawal. Having naloxone available is a part of “harm reduction” and it is the first step in saving lives from opioid addiction.

Treatment for addiction to heroin and opioid analgesics.

While opiate withdrawal caused by naloxone can be unpleasant, it is typically not dangerous. Naloxone is considered to be such a safe drug, the FDA is working on making it available over-the-counter. When a person is ready to seek addiction treatment, buprenorphine is an effective drug for treating opioid use disorder. Buprenorphine, the ingredient in Suboxone, can be used in the treatment of use disorder involving fentanyl, heroin or even prescription opiates. 

Should opiates be illegal?

While some experts say that the era of opioid use for pain relief is over, the fact is that narcotic medications can be effective and relatively safe. There is risk associated with all prescription drugs. This is particularly true with opiate pain relievers. Doctors must be careful to screen and monitor for signs of addiction and addictive behavior. By reducing the number of prescriptions for opiate pain killers in general, many cases of opioid addiction can be prevented. However, there will always be the need for opiate painkillers for some cases of severe pain.

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