Much of the current news about drugs has to with marijuana. Why is it legal in some places and not others? Should it be made legal throughout the country? What will happen if it is?
It feels like a pretty big issue, as often as you hear it discussed. But we have a bigger, more dangerous drug problem rising in the U.S. It dwarfs any concern the staunchest marijuana opponent might have. Opioid abuse.
Opioid drugs act on specific receptors in our bodies. They can reduce pain, produce euphoria, and lead to respiratory depression. This respiratory depression is typically how opioids cause death in an overdose. Prescription drugs such as oxycodone and illicit drugs such as heroin are opioids.
Opioids can quickly cause physical dependence. This means physical symptoms will result if you try to stop taking them. They are also highly addictive. In addiction, physical dependence exists alongside a psychological need for the drug. This is demonstrated by compulsive drug-seeking and abuse.
According to the CDC, 47,000 people died due to opioid overdose in 2014. Aside from that large number, the trends we are seeing in opioid overdose are enough to raise alarms.
2014 was a record year for deaths by opioid overdose – they increased 14 percent from the previous year. Deaths from overdose of prescription opioids increased by nine percent in that year. Heroin overdoses have tripled since 2010.
Two trends contribute to this dramatic increase in opioid overdoses. First, deaths from prescription opioids have increased for 15 years. This corresponds with the intense marketing of these drugs for chronic pain. They were originally intended to treat pain from cancer. This shift leads to long-term physical dependence on the drugs.
Second, the growing availability of high-purity heroin increased dramatically over the past decade. This results in increased street use of the drug. When a physician will no longer refill a prescription, readily available heroin can be attractive to someone in the grips of addiction. Heroin can also be far cheaper than street purchases of pharmaceutical opioids.
As a result, many opioid users end up in our prison system. Over 50 percent of federal prisoners are there for drug violations. To be fair, some were dealers or violent offenders, but others are there for possession.
Prison, it turns out, doesn’t do much to prevent recidivism. About 60 percent of drug offenders return to prison within three years of release. That carries a high price tag. The first year of a prison sentence is about five times the cost of drug treatment.
The CDC explains that we need a new approach to opioid addiction.
First, we must improve training and tools for medical personnel. Research published in the January 2016 Annals of Internal Medicine demonstrates this need. After a median of 299 days from surviving an opioid overdose, 91 percent of patients were prescribed opioids again. Clearer guidelines on prescribing practice must be outlined.
Second, access to life-saving drugs must be expanded. Naloxone blocks the effect of opioids in the event of an overdose. Making it available to law enforcement and in community pharmacies is literally a life-saving step.
Third, we must expand access to evidence based treatment – including medication-assisted treatment. This approach can relieve the symptoms of physical dependence while the behavioral aspect of addiction is addressed.
Finally, local public health agencies and law enforcement must work together to improve the response to this growing problem. Law enforcement is often the gatekeeper that determines how drug users interact with the legal system. How they do this is critical.
One town in Massachusetts has changed the way their police force deals with the drug problem. Last year, Gloucester, MA Chief of Police Leonard Campanello shared their new approach on the department's Facebook page. They would no longer arrest, but instead would assist drug users who asked for help. They placed these people in treatment facilities. Within the first two months, they placed 116 individuals into drug rehabilitation programs.
This local effort changed the lives of many families in Gloucester. Its success encouraged Chief Campanello to take this effort nationwide. The Police Assisted Addiction and Recovery Initiative is available to help local law enforcement agencies make the same impact in their own communities. If you would like to see your town implement the program, pass this information along to your police department or city council.
And if you or someone you love is struggling with addiction, hope and help are available to you.