Tuesday March 26, 2019

The opiate crisis in the U.S.

In the 1960s and 1970s, heroin began to receive national attention when certain musicians died from overdoses, as well as addiction in soldiers who were Vietnam War veterans.

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Africa
Opiates have some of the most cases of addiction due to their accessibility and intense ‘high’ - mostly beginning from something as simple as painkillers.

Nobody intends to suffer drug addictions, regardless of what drug it is you are dealing with. Among the drugs that are constantly in the media spotlight for their bad reputation of overdoses is opiates, which include several varieties that are widely popular for their relaxation effects.

Opiates have some of the most cases of addiction due to their accessibility and intense ‘high’ – mostly beginning from something as simple as painkillers. Contrary to many schools of thought, opiates are very easy to access and attach to, and before you know it, you are on a downward spiral, spending money on purchasing new supplies, and eventually leading to overdose and death.

Opioid abuse, which involves drugs such as heroin, prescription pain relievers as well as synthetic opioids is very serious – it affects diverse sectors of the economy including health – the cost of addiction treatments like opiate detox is about $78.5 billion annually.

This article will seek to examine the rate of opioid crisis, particularly in the U.S. It explores how the drug became a major problem in the consciousness of the American public, as many people suffer addictions to the drug regardless of their age or socio-economic status.

How do opiates work in the body?

Opiates have some of the most cases of addiction due to their accessibility and intense ‘high’ - mostly beginning from something as simple as painkillers.
How Opiate Works in Body

You may wonder what makes opiates so addictive, even when compared to other drugs. The use of opiates is very popular among various individuals and drug addicts because of their high risk involving overdoses and addiction, as well as their wide availability. Many people use them as both recreational drugs and for medical treatments (like anesthesia).

They work by sedating the part of the brain that controls homeostatic activities like breathing, which is the respiratory control part of the medulla oblongata. Therefore, when consumed in high doses, they present high possibilities for respiratory failure, respiratory depression, and death.

The epidemic is on serious levels in recent years, as the U.S. DEA (Drug Enforcement Administration) mentions that almost half of opioid fatalities in 2016 were due to prescription opioids. This makes them a greater cause of deaths currently than gun violence and car accidents.

History of opioid problems in the U.S. – a summary

In the 1960s and 1970s, heroin began to receive national attention when certain musicians died from overdoses, as well as addiction in soldiers who were Vietnam War veterans. When these cases began to rise in profile, medical professionals were hesitant to prescribe them to patients, except in the case of pill mills.

However, things took a turn in the 1990s, with pharmaceutical manufacturers assuring the medical community that there would be low cases of addiction to opioid painkillers, resulting in patients receiving these drug prescriptions at higher rates than before.In fact, since the 2010s, the rates of legal prescription opiates is steadily reducing, but overdoses are increasing at very high rates.

Some of the popular opioid drugs include:

Oxycodone

You may wonder what makes opiates so addictive, even when compared to other drugs. The use of opiates is very popular among various individuals and drug addicts because of their high risk involving overdoses and addiction, as well as their wide availability.
Drug Medicines

In America, this happens to be the most popular recreational drug. First available from the late 1930s, the FDA put it under the category of Schedule II drugs (it has a high chance of addiction and abuse).

Recent developments have led to the drug’s removal from sale by the FDA guidelines due to public health concerns. In 2012, the Canadian drug formulary also removed it from their list of legal drugs.

Heroin

This is a sort of clinic that gives patients narcotics without a real medical reason. They are a major cause of the opiate problem, as they are a major supplier chain for black markets that deal with illegal painkillers.
Medicines

Another drug in high circulation (even though it is illegal),many individuals who abuse heroin are actually abusers of prescription opioids previously, making it dangerous to have an addiction to painkillers. Its use has been on the rise for several years, as indications show more than 600,000 Americans consume the drug (in 2009-2011). its use has steadily increased over several years making it hard to keep track over related deaths or rehab treatments.

Fentanyl

This is a more recent opioid painkiller that is synthetic in nature. It happens to be 50-100 times stronger than morphine and 30-50 times stronger than heroin. In fact, doses as little as 2mg are lethal. In fact, the DEA recommends that officers should not touch or smell the drug as it can result in fatalities.

Fentanyl was not common in the past, but nowis a major issue especially with the bigger cities such as Chicago and Philadelphia.

What are Pill mills?

This is a sort of clinic that gives patients narcotics without a real medical reason. They are a major cause of the opiate problem, as they are a major supplier chain for black markets that deal with illegal painkillers. They can charge exorbitant fees for the patients, therefore making large profits for their businesses. Some states such as Florida prohibit the sale of prescription opiates to curb the problem.

Also Read: Top 5 Ways to Keep Your Florida Home Safe from Pests

What is the NIH and HHS doing to address the problem?

It is no secret that the rise in opiate use has become a big problem. However, the U.S. DHIH (Department of Health and Human Services) is focusing the fight against opioids through five pillars, which are:

Improving the understanding of the problem through public health monitoring

Among the major issues that lead to the problem is stigmatization, which leads to avoidance of the issue. However, experience teaches you that avoiding problems is not equal to solving them, and the key to starting the recovery process is to combat the problem head-on.

This also relates to public education and awareness, so that if you see the signs in your loved one or are going through it, you will know what to do before the problem escalates.

Enhancing access to recovery services

Drug use is associated with stigma in many cultures, even within America. It is therefore vital that all agencies involved step up recovery centers to reduce stigma. This also encourages public conversations around the issue and assists you to recover in case you are battling an addiction.

Giving support to addiction and pain research

Drug use for many individuals stems from a painful situation, and they want to seek comfort in drugs, even though it is not healthy. In order to prevent this, more resources need to go to conducting research and seeking methods that help in managing addictions, including opioid withdrawal.

Final thoughts

Opioid use is not only a big issue within the U.S. in terms of health and loss of productivity, but also an increase in fatalities from overdoses is part of it. The problem lies with certain factors helping in its spread and use, such as its easy accessibility. However, concerted effort by all the parties in the case can help curb the issue.

Next Story

Patients With Hard-To-Treat Depression, A New Drug ‘Special K’ At Rescue

Depression is among the leading causes of disability in the U.S. and is being closely monitored by health authorities amid rising suicides nationwide.

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Depression
A vial of ketamine, which is normally stored in a locked cabinet, is seen in Chicago, July 25, 2018. VOA

A mind-altering medication related to the club drug Special K won U.S. approval Tuesday for patients with hard-to-treat depression, the first in a series of long-overlooked substances being reconsidered for severe forms of mental illness.

The nasal spray from Johnson & Johnson is a chemical cousin of ketamine, which has been used for decades as a powerful anesthetic to prepare patients for surgery. In the 1990s, the medication was adopted as a party drug by the underground rave culture due to its ability to produce psychedelic, out-of-body experiences. More recently, some doctors have given ketamine to people with depression without formal FDA approval.

The Food and Drug Administration approved Spravato as a fast-acting treatment for patients who have failed to find relief with at least two antidepressants. Up to 7.4 million American adults suffer from so-called treatment-resistant depression, which heightens the risk of suicide, hospitalization and other serious harm, according to the FDA.

The drug will cost between $590 and $885 depending on the dosage and before various insurance discounts and rebates.

There have been no major pharmaceutical innovations for depression since the launch of Prozac and related antidepressants in the late 1980s. Those drugs target the feel-good brain chemical serotonin, and can take weeks or months to kick in.

Ketamine and J&J’s version work differently than those drugs, targeting a chemical called glutamate that is thought to restore brain connections that help relieve depression.

When the drug works, its effect is almost immediate. That speed “is a huge thing because depressed patients are very disabled and suffer enormously,” said Dr. John Mann, a psychiatrist and researcher at Columbia University. If the drug doesn’t work, physicians can quickly switch to other options, he noted.

The FDA approved Spravato, known chemically as esketamine, based on study results that showed patients taking the drug experienced a bigger improvement in their depression levels than patients taking a sham treatment, when measured with a psychiatric questionnaire.

The drug is designed to be lower-dose and easier to use than ketamine, which is normally given as an intravenous infusion.

Robin Prothro, 60, began taking antidepressants more than 20 years ago. But she says none of the five medications she tried relieved the depression that has stymied her personal and professional life.

Since enrolling in a Spravato trial two years ago, Prothro says her depression has lifted and she’s returned to hobbies she abandoned years ago, like gardening.

She takes the drug every two weeks at her psychiatrist’s office while reclining in a comfortable chair.

“You can feel it coming on, it’s a strong drug,” she said, describing colors and shapes that drift before her eyes. “I just let the drug work. I close my eyes and my mind is amazingly quiet.”

Psychedelics reconsidered

The ketamine-like drug is the first of several psychoactive substances making their way through the U.S. regulatory process as physicians search further afield for new therapies. Researchers are conducting late-stage trials of psilocybin, the active ingredient in magic mushrooms, and MDMA, a euphoria-inducing club drug, as potential treatments for depression and post-traumatic stress disorder.

Lauren Pestikas sits as she receives an infusion of the drug ketamine during a 45-minute session at an outpatient clinic in Chicago, July 25, 2018.
Lauren Pestikas sits as she receives an infusion of the drug ketamine during a 45-minute session at an outpatient clinic in Chicago, July 25, 2018. VOA

“Substantially different agents are only rarely appearing from pharmaceutical companies or other laboratories,” said Dr. Paul Summergrad, a psychiatrist at Tufts University. “That’s prompting people to investigate other compounds.”

Unlike ketamine, psilocybin and MDMA have no legal medical use. Classified in the same category as heroin and LSD, they are tightly restricted by the federal government. But the FDA’s approval of esketamine could smooth their path.

Burden of depression

Depression is among the leading causes of disability in the U.S. and is being closely monitored by health authorities amid rising suicides nationwide. In 2017, the U.S. suicide rate rose to 14 deaths per 100,000 people, the highest rate in at least 50 years, according to federal records.

Government officials haven’t suggested an explanation for the trend, though academic researchers point to the nation’s widening income gap, financial struggles and divisive politics.

J&J’s drug will be subject to a number of restrictions due to its abuse potential, side effects and lingering safety questions.

The drug will only be given by accredited specialists who must monitor patients for at least two hours after administration, due to its trippy, disorienting effects. Additionally, all patients will be tracked in a registry to monitor long-term safety and effectiveness.

The immediate impact of ketamine is thought to last just four to seven days and there’s no consensus yet on how long patients can benefit from ongoing treatment.

sad
Depression is among the leading causes of disability in the U.S. and is being closely monitored by health authorities amid rising suicides nationwide. Pixabay

Still, there are few other options for patients who fail to respond to antidepressants. The most effective treatment in such cases, electroshock therapy, requires patients to be fully sedated and can cause persistent memory loss.

Wall Street has high expectations for J&J’s medication, with analysts predicting more than $600 million in annual sales by 2022. But J&J will face competition in the marketplace.

A decades-old drug, ketamine is already used off-label to treat depression by some doctors. At least 150 clinics around the U.S. provide treatment with various forms of the drug, which is available as a low-cost generic. Patients often pay hundreds or thousands of dollars for intravenous infusions of the drug over several weeks or months. Such therapies are generally not covered by insurance because they haven’t been approved as safe and effective by FDA regulators.

Also Read: Hospital in Jordan Gives War Victims New Hope, Develops 3D-printed Prosthetics for War Victims

Some doctors plan to offer both ketamine and the new J&J drug.

Dr. Steve Levine says having FDA-approved standards for dosing and administering the new drug should raise standards in the field and drive out some of the bad actors who are not qualified to treat depression.

“This is going to bring in some standards, regulation and it’s going to make it safer and more accessible to patients,” said Levine, who serves as vice president of the American Society of Ketamine Physicians, a group representing doctors, nurses and others using ketamine for treating depression or other non-approved uses. (VOA)