America is dying: Opioid addiction

The opioid epidemic has pervaded American life. This public health crisis began when physicians over-prescribed this highly effective painkiller, not knowing its addictive nature. Efforts to decrease opioid prescriptions caused many to turn to purchasing substances such as heroin and fentanyl, which are illegally manufactured and extremely potent. Within the past decade and a half, overdoses from prescription opioids have accounted for more than 165,000 deaths in the United States. This epidemic requires some serious attention. Education and prevention are valid means to address this public health issue, but an epidemic of this magnitude requires more than just lectures and campaigns.

A novel idea has emerged out of cities like Columbus and Los Angeles which are piloting a controversial strip test that allows addicts to test their drugs for traces of fentanyl. While these strips are not 100 percent effective and can even yield some false negatives, they will reduce the harm of illegally obtained street drugs. Even giving addicts the opportunity to decide how to take the drug (i.e. shoot half of the drug or abstain completely) could be both cost-effective and life-saving. When coupled with other harm reduction interventions such as clean needle exchanges, which subsidize access to sterile needles, this could be a useful method to reduce overdose deaths.

Additionally, Narcan, an easily-administered nasal spray, can be used to reverse the effects of an opioid overdose. Expanding accessibility to this drug could mitigate overdose deaths by equipping the community to act when a need arises. During an emergency, even two minutes could make the difference between life and death. Recently, efforts have been taken to supply every library and YMCA with a Narcan supply. Continuing to supply high-risk areas with Narcan, including high schools and colleges, will be largely beneficial. Taking it one step further, Surgeon General Dr. Jerome Adams believes average citizens should carry this drug because “keeping it within reach could save a life.”

After overdoses, it is integral that systems are set in place to promote healing and prevent relapse. Most rehabilitation centers are largely ineffective, particularly in regard to opioid addiction. Short-term residential rehab programs, which last about two to three weeks, have a relapse rate of almost 100 percent. However, a new treatment plan is being tested called Medication Assisted Treatment (MAT). MAT is an evidence-based practice which uses a mix of three drugs to reduce opioid cravings. Naltrexone blocks the brain’s opioid receptors, and the other two drugs, known as methadone and buprenorphine, stop the body’s withdrawal symptoms. MAT is unavailable to many patients because physicians who can administer this treatment require additional training to obtain approval from the Food and Drug Administration. Methadone clinics, which differ from MAT in that they only offer one of the three drugs, are in high demand. Unfortunately, long wait times prohibit access for many addicts. Mandating training for physicians in hospital settings to offer MAT to patients would be consequential in curbing this epidemic. It is time that public health professionals, doctors, politicians and innovators come together to end the vicious cycle of opioid addiction. Drug addiction is a medical condition and requires the same attention as any other disease.