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The Opioid Epidemic

The Opioid Epidemic

We have all been hearing about the growing devastation of opioid abuse in the United States, especially for older men and women. In 2015, 2.7 million Americans over the age of 50 abused painkillers, meaning they took them for reasons or in amounts beyond what the doctor prescribed.

Nearly 14,000 people over 45 died from an opioid overdose in 2015. The hospitalization rate due to opioid abuse has increased 4x for those 65 and older in the past two decades. The chief culprits are opiate-based pain relievers such as Vicodin (hydrocodone), OxyContin, Percocet (oxycodone), codeine, morphine, and Actiq (fentanyl), the flavored lollipop that is 100 times stronger than morphine and very overprescribed, with only 10% of its sales for its original indication to treat cancer pain.

http://www.huffingtonpost.com/2011/12/22/americas-deadliest-pills_n_1166033.html

Physical dependency can occur within one week, meaning there would be some discomfort or side effects when use is stopped, says Andrew Kolodny, Executive Director of Physicians for Responsible Opioid Prescribing.

Experts believe this epidemic has blown up because pharmaceutical companies have marketed opioids aggressively to physicians, especially after the Federal Drug Administration approved OxyContin in 1995.  Prior to this, painkillers were primarily used for short term pain relief. After this, opioid prescriptions by doctors increased dramatically, including for longer term pain relief.  There was a grave miscalculation overestimating the benefits of opioids for pain management and underestimating the risks for longer term pain management. Medical schools taught that opioid medication was not addictive as long as it was given to someone in legitimate pain, something we now know is not true. There was also a misconception that older people would not become addicted to these medications.

AARPBULLETIN/RealPossibillities June 2017 John Rosengren

What to Do

We need to have many more treatment centers for treatment of opioid addiction, especially oriented toward treatment for older patients. There are medications that can help as well and doctors need to be educated about these medications. We also need to have a major change in attitudes about opioid addiction.  There is a widespread mistaken belief that it is a moral failing instead of a chronic medical condition that requires treatment.

On a personal level, be very careful when getting prescriptions for pain. They are very effective for very short-term pain relief, three days worth is typically sufficient. But for chronic pain relief, be sure to talk to your doctor about addiction potential. Look for non-addictive and nondrug pain management solutions. If you wind up taking an opioid for chronic pain, the CDC advises starting at the lowest effective dose and checking in with your doctor regularly to make sure that the drug is helping and that you are able to take it safely.

If you are concerned that you have become addicted to a prescription medication, talk to a therapist or find a treatment program. Get professional help- it is dangerous to manage on your own.

http://www.consumerreports.org/pain-relief/addictive-pain-medication-how-protect-yourself/

Naomi Effort MA, LCPC and

Joleen Hartland MS, LCPC

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