What You Really Need to Know About the U.S. Opioid Epidemic

The first thing that you need to know about the U.S. opioid epidemic is that it is still going strong. In fact, the number of opioid deaths increased in 2020, 2021, and 2022, the most recent years for which statistics are available.

So, while the epidemic may not be getting the same level of news coverage that it received back in the early 2010’s, when opioids were the lead story on all the popular news programs, it is still very much here and still causing lots and lots of unnecessary deaths.

Here’s what you need to know about the U.S. opioid epidemic … the very real and very dangerous U.S. opioid epidemic, that is.

The National Institute on Drug Abuse reports that opioid-involved overdose deaths increased “from 21,089 in 2010 to 47,600 in 2017 and then remained steady through 2019.”

But any hopes that the epidemic had hit its peak were soon dashed when the number of opioid-related deaths rose significantly to 68,630 in 2020 and to 80,411 in 2021.

The New York Times is now reporting that the number of opioid deaths in 2022 rose to a shocking 110,000.

Clearly, this is not an epidemic that is on the downswing. The problem is getting worse, not better! Look at these additional opioid statistics:

●The National Institute on Drug Abuse says that each day more than 115 people in the United States die after overdosing on opioids.

●The U.S. Department of Health and Human Services declared a public health emergency related to the abuse of opiates.

So, how did we reach this point, where opioid addiction is a national health emergency? Let’s look at the history of opioids in the U.S.

There is a saying – “those who don’t know history are doomed to repeat it.” That’s why it is important to understand how the opioid epidemic started and how it has grown into the major problem that it is now.

Simply put, if you are seeking to understand all you can about the U.S. opioid epidemic, its history is a great place to start.

So, what is that history?

The opioid epidemic itself can be traced back to the 1990s, when there was a push to start alleviating the burdens of pain by advocacy groups. Large pharmaceutical companies saw an opening and enticed doctors – in part through misleading marketing about the safety and efficacy of drugs – to prescribe opioids to treat all sorts of pain symptoms.

This gave rise to the proliferation of drugs like hydrocodone, oxycodone, morphine, methadone, and fentanyl as America became the world’s leader in opioid prescriptions.

By 2015, the CDC says that enough opioids were prescribed to medicate every American around the clock for three weeks.

As publicity about the opioid crisis and the dangers of these prescription drugs has surged, doctors have begun looking for not just viable alternatives to opioid prescriptions but also ways to break opioid addiction.

Opioids are commonly prescribed because of their effective analgesic, or pain-relieving, properties. Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract.

When these compounds attach to certain opioid receptors in the brain and spinal cord, they can effectively change how a person experiences pain.

In addition, opioid medications can affect regions of the brain that mediate what we perceive as pleasure, resulting in the initial euphoria that many opioids produce. These prescription drugs can also produce drowsiness, cause constipation, and, depending upon the amount taken, depress breathing.

That’s right, taking a large single dose could cause severe respiratory depression or death. Also, opioids may interact with other medications and, thus, are only safe to use with other medications under a physician’s supervision.

Typically, they should not be used with substances such as alcohol, antihistamines, barbiturates, or benzodiazepines. Since these substances slow breathing, their combined effects could lead to life-threatening respiratory depression.

Long-term use can also lead to physical dependence – the body adapts to the presence of the substance, and withdrawal symptoms occur if use is reduced abruptly. This can also include tolerance, which means that higher doses of a medication must be taken to obtain the same initial effects.

These are important things to remember when thinking about the U.S. opioid epidemic and its massive growth over the past several years.

Please also note that physical dependence is not the same as addiction – physical dependence can occur even with appropriate long-term use of opioids and other medications. Addiction, by the way, is defined as compulsive, often uncontrollable drug use in spite of negative consequences.

All of this is why it is essential that individuals taking prescribed opioid medications not only be given these medications under appropriate medical supervision, but also should be medically supervised when stopping use in order to reduce or avoid withdrawal symptoms.

Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg movements.

Individuals who become addicted to prescription medications can be treated. Options for effectively treating addiction to prescription opioids are drawn from research on treating heroin addiction. Some pharmacological examples of available treatments include:

●Methadone, a synthetic opioid that blocks the effects of heroin and other opioids, eliminates withdrawal symptoms and relieves craving. It has been used for over 30 years to successfully treat people addicted to opioids.

●Buprenorphine, another synthetic opioid, is a recent addition to the arsenal of medications for treating addiction to heroin and other opiates.

●Naltrexone is a long-acting opioid blocker often used with highly motivated individuals in treatment programs promoting complete abstinence. Naltrexone also is used to prevent relapse.

●Naloxone counteracts the effects of opioids and is used to treat overdoses.

In response to the increasing number of opioid overdose deaths, the U.S. Federal Government has begun a series of initiatives designed to slow and ultimately reverse the epidemic’s growth.

Those measures include:

●Passing legislation, such as the Comprehensive Addiction and Recovery Act (CARA) and the SUPPORT for Patients and Communities Act, which are designed to expand access to treatment, improve prescription drug monitoring programs, and enhance prevention efforts.

●Allocating funding to support various aspects of opioid addiction prevention and treatment, including increasing resources for state and local governments, healthcare providers, and law enforcement agencies.

●Expanding access to medication-assisted treatment (MAT), which combines medications with behavioral therapy to address opioid addiction. Initiatives were also aimed at increasing the number of healthcare professionals authorized to provide MAT.

●Implementing or strengthening Prescription Drug Monitoring Programs (PDMPs) in many states to help track and prevent over-prescription of opioids. These programs provide doctors and pharmacists with information about a patient's prescription history.

●Launching public awareness campaigns to educate the public about the risks of opioid misuse, proper pain management, and the importance of safe disposal of prescription medications.

●Having law enforcement target illegal opioid distribution and trafficking networks, including increasing cooperation between federal, state, and local law enforcement agencies.

●Making Naloxone, an opioid overdose reversal medication, more widely available to first responders, healthcare providers, and community members to help save lives in cases of overdose.

●Also, programs are being implemented to provide support to families affected by opioid addiction and to help communities develop comprehensive strategies to address the crisis.

When it comes to opioids, the first step to getting help is becoming aware that there is a problem.

If you know someone that you think may have a problem with opioids, ask them the following questions:

1.Have you ever felt you should cut down on your drug use?
2.Do you ever use drugs when you’re alone?
3.Have you ever used more of a drug than you intended in a given period of time?
4.Have you ever used drugs for a longer period of time than you originally intended?
5.Have you ever used more than one drug at a time?
6.Concerning your use of drugs, has anyone ever told you that you use too much?
7.Have you ever taken one drug to overcome the effects of another?
8.Have you ever thought that your life might be better if you didn’t take drugs?
9.Have you ever felt angry at yourself or guilty because of your drug use?
10.Do you regularly use a drug at certain times of the day or on certain occasions, for example, when you go to bed, when you wake up, before or after a meal, or before or after sex?
11.Have you ever lied about your drug use to family members or friends?
12.Have you ever lied to a doctor or faked symptoms to get prescription drugs?
13.Have you ever stolen drugs?
14.Have you ever stolen money or material goods that you could sell to obtain drugs?
15.Have you ever done things to obtain drugs that you later regretted?
16.Has your drug use ever caused problems for you with school or with work?
17.Have you noticed that you need to use more and more of a drug to get you high?
18.Do you experience withdrawal symptoms when you go without drugs for a few days?
19.Do you panic when your drug supply gets low?
20.Have you ever done something when you were high that you felt guilty about later?
21.Have you ever gotten into fights when high on drugs?
22.Have you ever been arrested for any drug-related activity (including possession)?
23.Have you ever been diagnosed with a medical problem related to your drug use?
24.Have you ever overdosed on a drug?
25.Have you ever attended a treatment program specifically related to drug use?
26.Have you associated with people with whom you normally wouldn’t just so you could have access to drugs?
27.Have you stopped associating with any of your friends because they don’t use drugs as much as you?

If the person answers “yes” to any two of the above questions, this is a sign that they could have a problem with drugs. If they answer “yes” to any three, the chances are high that they have a problem with drugs. If they answer “yes” to four or more, they definitely have a problem with drugs.

In general, a person becomes addicted to opioids when they start needing more of the drug to get the same effects, and they start to feel like they can’t get along without that drug.

They may try to quit, but the withdrawal symptoms are typically just too much to take, so they continue using.

To avoid becoming another number in the U.S. opioid epidemic, there are several things a person can do, including:

●Undergoing MAT, which we mentioned earlier. This treatment combines medications (such as methadone, buprenorphine, or naltrexone) with behavioral therapy to help manage withdrawal symptoms, reduce cravings, and prevent relapse.

●Medical detox, often performed in a supervised setting, can help manage withdrawal symptoms as the body clears the opioids from the system.

●Cognitive Behavioral Therapy (CBT) helps individuals identify and modify negative thought patterns and behaviors associated with opioid use.

●Motivational Enhancement Therapy helps individuals find internal motivation to change their behaviors and overcome addiction.

●Group therapy or support groups can provide a sense of community and shared experiences, which can be empowering and motivating.

●Connecting with others who have successfully overcome opioid addiction can provide valuable insight, encouragement, and inspiration.

●Establishing a daily routine that includes regular exercise, proper nutrition, and adequate sleep can help improve physical and mental well-being.

●Learning healthy coping mechanisms for stress and triggers can reduce the risk of relapse.

●Learning healthy ways to cope with triggers and cravings, such as deep breathing exercises, calling a supportive friend, or engaging in a hobby.

Remember, overcoming opioid addiction is a challenging process that requires commitment, patience, and perseverance and may also require medical treatment, therapy, and support from loved ones.

It's important to seek professional help and develop a comprehensive plan tailored to your individual needs and circumstances. Consulting with a medical provider or addiction specialist is a crucial first step toward recovery.

It is also important to learn all you can about the U.S. opioid epidemic so that you can make informed choices going forward.

1.Drug Overdose Death Rates
2.Understanding Drug Overdoses and Deaths
3.CMS.GOV - Ongoing emergencies & disasters