Every day more than 115 Americans die after overdosing on opioids. Opioid misuse and addiction are now at epidemic proportions, and public health officials have called the current opioid epidemic the worse drug crisis in American history.
In 2015, 2.1 million people had an opioid use disorder, and 42,249 people died from opioid overdose, making it the leading cause of accidental death in the United States.
Beyond affecting the health of the public, this crisis also has many social and economic impacts. The Centers for Disease Control (CDC) estimates that the total economic burden of opioid misuse is $78.5 billion a year.
In 2017 the Department of Health and Human Services and the Trump administration declared the opioid crisis as a public health emergency, a move that not only brings the issue to the forefront of conversation but also typically generates a significant amount of money to help national, state and local agencies work to address the issue.
Data suggests that Colorado is no different, and opioid misuse and addiction have been a crisis for many years. Colorado’s drug overdose rate is significantly higher than the national average and has quadrupled since 2000.
So what are opioids and how do prescriptions from legitimate, well-meaning doctors turn into heroin addiction, death and a national crisis? Opioids are part of a drug class that includes the illegal drug heroin as well as the powerful pain relievers oxycodone, hydrocodone, codeine, morphine, fentanyl and many others.
In the late 1990s, pharmaceutical companies assured doctors that patients would not become addicted to opioids, leading the medical community to prescribe these drugs at greater and greater rates.
Misuse of these prescription drugs started soon after, leading to widespread abuse and addictions. By the time it was clear to everyone that opioids were in fact very addictive, the crisis was well underway.
Up to 29 percent of those who are prescribed opioids for chronic pain misuse them, 12 percent go on to develop an opioid use disorder, and 6 percent of those who misuse prescription opioids transition to heroin because it is less expensive. What’s more startling is that 80 percent of heroin users first misused prescribed opioids.
Though the crisis may seem inescapable, there is hope. There are a number of strategies, created by the Department of Health and Human Services, being implemented across the country. These strategies include:
Increased access to treatment and recovery services: Ninety percent of Americans with opioid addiction are not getting treatment. HHS has dedicated $485 million in grants to support states in implementing evidence-based prevention and treatment activities.
Beyond typical treatment and prevention programs, this funding will also support training for health professionals, technological investments and support for the Prescription Drug Monitoring Program.
Opioid overdose reversal drugs: Expanding access to naloxone, the primary drug used to reverse overdose, is helping to pull many Americans out of addiction. This lifesaving drug is affordable and easy to use, and part of the national strategy is to make sure hospitals and police departments have the access and training to use this medication.
Public health surveillance and research: Accurate and timely data is vital in the fight against opioid addiction. The latest statistics come from 2015, which in many ways is very relevant data, but when fighting an epidemic of this proportion that data is old news. Providing grants to state and local authorities can help them track developments and trends and respond in real time.
Pain research and management: Though naloxone is helpful in fighting addiction, and new drugs are being tested as we speak, to truly stop the crisis we have to avoid creating dependence in the first place.
There must be a paradigm shift in managing pain – both for patients and doctors. The National Institutes of Health is partnering with pharmaceutical companies and research centers to develop safe, effective and nonaddictive ways to manage chronic pain.
State legislatures are also taking action, introducing measures to regulate pain clinics and limit the quantity of opioids that doctors can dispense.
Each day we are met with one crisis after another, and it is easy to become numb to the numbers. But this crisis is sparing no one. There is no state, city or town not affected by opioid addiction. There is no age group, social class or race not affected by opioid addiction. It is tearing apart people, families, communities and a nation day by day.
Chaffee County Public Health, along with many local and regional stakeholders, is committed to addressing this crisis through a variety of ways. Because of a grant from the Colorado Department of Public Health and Environment, provider and prescriber education and community awareness events are underway.
In addition, this grant funding will allow us to form a regional opioid coalition with focused, action-oriented workgroups. Chaffee County Public Health recently purchased safe needle handling kits so that when community partners and members encounter used injection drug needles, whether on a trail, in a parkor in another public place, they have the tools needed to confidently remove the needle from the area, returning it to Public Health for proper disposal.
Likewise, Chaffee County Public Health is working with local partners to explore a safe needle disposal pilot program.
Through our Regional Health Connector program that serves Chaffee, Lake, Fremont and Custer counties, opioid training and expertise is being brought to our community, including the use of naloxone. If you would like to find out more about these efforts, please call Chaffee County Public Health at 539-4510.
Emily Anderson is a registered nurse at Chaffee County Public Health.