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Opioid abuse on the rise
Opioid-related deaths have been on the rise in recent years and now surpassed breast cancer deaths. In 2016 over 63,000 deaths were related to a drug overdose with over 42,000 being related to opioids, exceeding breast cancer deaths by over one thousand deaths. 2016 has been the deadliest year of the opioid epidemic. Opioids continue to account for the highest proportion of prescription drug abuse problem, especially concerning abuse and mortality.
On The Rise
According to the Center for Disease Control (CDC), drug-related deaths have increased in every age group studied. Rates in 2016 were highest for persons aged 25-34, 35-44, and 45-54. The most marked increase was in persons aged 15-24, 25-34, and 35-44 with increases of 28%, 29%, and 24% respectively. Nearly every category of opioid abuse-related deaths has increased since 1999. Synthetic opioids other than methadone (e.g., fentanyl, tramadol) increased from 0.3 per 100,000 persons in 1999 to 1.0 in 2013, then to 6.2 in 2016. Between 2013 and 2016 synthetic opioids other than methadone increase 88 percent annually.
West Virginia, Ohio, and New Hampshire were states with the highest rates of overdose. West Virginia’s overdose rate (19.8 overdose deaths for every 100,000 people) was 2.5 times higher than the nation’s average. Provisional data for 2017 is suggesting the trends will continue and that drug overdose deaths will continue to rise. "Based on what we're seeing, it doesn't look like it's getting any better," said Bob Anderson, chief of the mortality statistics branch at the National Center for Health Statistics.
Extensive Efforts Put in Place
In October of 2017, President Trump declared the opioid crisis a public health emergency helping to create funding and legislation to abate the crisis. This wasn’t the first time opioids abuse has been addressed, but it highlighted the need for more serious efforts. Addiction specialist Dr. Andrew Kolodny said that despite the devastating overdose numbers, there appeared to be some indicators of good news. "Even though deaths are going up among people who are addicted heroin users, who use black-market opioids ... it's possible that we are preventing less people from becoming addicted through better prescribing," said Kolodny, executive director of Physicians for Responsible Opioid Prescribing.
On March 29, 2017, President Donald J. Trump signed an Executive Order establishing the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The Commission on Combating Drug Addiction and the Opioid Crisis issued its final report in November with over 50 recommendations for dealing with the crisis. The report highlighted four main areas to help direct future efforts.
Federal Funding and Programs
The final report urges the use of federal funds for life-saving programs and urges states to block funding to programs that have a significant burden on applications and reporting processes. The report is setting up accountability through the Office of National Drug Control Policy (ONDCP), who will review every federally funded program.
Opioid Addiction Prevention
In order to aid in opioid addiction prevention the report recommends implementing prescribing guidelines, regulations, and education, which is not standard practice today. Federally funded programs will need to adhere to the Prescription Drug Monitoring Act (PDMP) which allows providers to track controlled substances prescriptions. Lastly, it is recommended that supply reductions and enforcement strategies be put in place.
Opioid Treatment, Overdose Reversal, and Recovery
The Commission recognizes that treatment outcomes need to focus on long-term outcomes without relapse, a major issue with substance abuse that is often left unaddressed. New guidelines and policies for reimbursement should be developed for Recovery Support Services. The Commission and other government agencies suggest identifying successful recovery programs that offer high-quality service and increasing their capacity.
Research and Development
The Commission recommends that federal agencies engage in a comprehensive review of current research programs and establish goals for pain management and addiction research (both prevention and treatment). Further, the use of technology-assisted monitoring should be explored to help monitor high-risk patients. Lastly, the Commission recommends that the FDA establish guidelines for post-market surveillance related to diversion, addiction, and other adverse consequences of controlled substances.
Opioid abuse is increasing at alarming rates across the U.S. Nobody could have predicted the magnitude of this issue. With previous efforts not adequately addressing opioid abuse in our nation, the newly developed Commission has put together an exhaustive report to combat the harmful effects opioid abuse has on individuals and our nation.