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Monday, May 6, 2019

Opioid Addiction by Ginger Pace


Introduction

Picture yourself just sitting down to enjoy your meal. As you are taking your first bite and suddenly you hear and feel the sound of something cracking in your mouth. So, you jump, stop chewing, and clinch your mouth with your hand. To your dismay you immediately spit the partially chewed food onto your plate. As you are looking down at the food on your plate, what do you see, but part of your tooth setting there. You get up and go to rinse your mouth out to get a good look at the damage, when it hits you like hard. You scream in agony as the pain shoot up your face. This is how it all started, with a toothache. Then came the opioids.  

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History 

Opioids are in a couple of different classes; some are natural or synthetic chemicals. They interact with opioid receptors on nerve cells in the body and brain and reduce the intensity of pain signals and feelings of pain (“Commonly Used Terms” 1). This class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain medications available legally by prescription, such as oxycodone, hydrocodone, codeine, morphine, and many others (1). Opioid pain medications are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (1).  Thought-out history opioid use has been common to treat pain. Opium became available in America around the late 1700; “They used opioids to treat soldiers in the 1860s during the Civil War and many soldiers became addicted to them” (“History of the Opioid Epidemic” 1). By the late 1800’s there was a rise in opioid addiction due to over the counters availability (1). Bayer brands sold heroin as a cough suppressant and pain reliefer (1). Early 1900’s morphine was interduces as a pain reliever (1). Americans began to crushing opioids and snorting them for pleasure (1).  By 1914, the Harrison Narcotics Act regulated opioids to limit their recreational usage (1). In the 1970s, the stigma of addiction led doctors to avoid prescribing opioids and instead opting for surgical operations to block nerves from receiving pain signals (1). By 1976 Percocet and Vicodin were approved by the Federal Drug Administration (1). Although in the 1980s and 1990s, opioids began to be used again to relieve pain from chronic disease (1).

Social effects

 In the early 2000s, opioid use increased dramatically. Morphine and hydromorphone both increased over 50% and fentanyl were over 200% and oxycodone were increased by over 400%. Around the mid-2000s, teens started using opioids found in their parent’s medicine cabinets (1). In 2016, over 200,000 kids between the ages of 12 to 17 used pain relievers (including opioids) for non-medical reasons, and over 100,000 were addicted to prescription drugs. It is only getting worse with teens. Teenage opioid addiction rates increased by 19 percent between 2014 and 2015. When asked, 12th-grade students identified the ease of availability of Heroin as a factor in their use (“The Problem of Teenage Opioid Addiction”1).

By 2010, the use of opioid user went to using heroin (“History of the Opioid Epidemic” 1). By 2013, over 20,000 babies were born drug-dependent (1). In 2015, the over dose death grew to over 50,000. In 2016, Surgeon General, Vivek Murthy, reports: “for far too long people have thought about addiction as a character flaw or a moral failing (1). Addiction is a chronic disease of the brain and its one that we have to treat the way we would any other chronic illness: with skill, with compassion and with urgency” (1). Overdose deaths involving opioids, including prescription and illegal opioids, are six times higher in 2017 than it was in 1999 (“Understanding the Epidemic” 1). There are over 140 deaths a day in the United States due to overdose. This means every three weeks we have around the same about of deaths as 9/11 (page 2). With the numbers of use raising in all ages and the over does death on the raise every year, this epidemic needs to be addressed.

Examples

What seems so long ago, still has many side effects on our family today. It all started about eight years ago. My husband always had bad teeth. One morning after breakfast a tooth broke and he was in severe pain. That’s how it all began.  My husband was working a great job, he was the general manger of a sales store and I was hired to work as administration. The only down side to his promotion was he was never home. He worked hard and many hours. Little did our family know, we were losing my husband to an opioid drug addiction. He needed those
opioids to keep himself going he would say.  Everything fell apart. Within a few years our family lost everything, jobs, house, cars, and even the ability to feed my kids. My husband went from being head of the house hold to be a burden to the family. We lost a father, a husband, and a
great over all hard worker to this addiction. He chose to go to rehab. In rehab it really helped. What we thought was a fix to his addiction, was only a band-aid. The doctors at the time told us how great this new drug that came out was helping people with opioid addiction. So, we thought great he will be fixed. We were wrong. This drug is now his new addiction and must work and deal with this every day.

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Solutions

  To handle the opioid crisis in the United States, the U.S. Department of Health and Human Services began focusing its efforts on a couple of areas (National Institute on Drug Abuse 1). Some of these are improving access to treatment and recovery services, providing support for cutting-edge research on pain and addiction, and advancing better practices for pain management (1). The National Institutes of Health, a component of HHS, is the nation's leading medical research agency helping solve the opioid crisis by discovering new and better ways to prevent opioid misuse, treat opioid use disorders, and manage pain (1).

In the summer of 2017, NIH met with pharmaceutical companies and academic research centers to discuss different ways to tackle the epidemic. Here are a few ideas they came up with, a non-addictive strategy to manage chronic pain, and new innovative medications and technologies to treat opioid use disorders; “In 2018, at the National Rx Drug Abuse and Heroin Summit, NIH Director Francis S. Collins, M.D., Ph.D., announced the launch of the HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis” (National Institute on Drug Abuse 1). 
HEAL explored into therapeutic options for opioid addiction (“HEAL Initiative Research Plan” 1). Some of the treatment options for opioid addiction are needed to promote long-term recovery in more patients (1).  Methadone, buprenorphine, and naltrexone are approved by the U.S. Food and Drug Administration (FDA) to treat opioid addiction (1). Another popular brand of drug on the market for recovered patients is suboxone.

Suboxone is the brand name for a prescription medication used in treating those addicted to opioids (“Suboxone” 1). It contains the ingredients buprenorphine and naloxone (1). Buprenorphine, a partial opioid agonist, blocks the opiate receptors and reduces a person’s urges (1). The second ingredient, naloxone, helps reverse the effects of opioids (1). Together, these drugs work to prevent withdrawal symptoms connected to an opioid addiction; “Suboxone has become the preferred treatment medication for opioid addiction. It is now used more than methadone, which can be habit-forming.” (“Suboxone”1). The suboxone works by attaching to the receptors and partially blocks the effects of other opioids ("Suboxone Detox Program” 1). It is as if Suboxone takes up the opioid parking spaces in the brain, making it difficult for opioids to park there (1). With daily maintenance doses, Suboxone continues to keep the brain’s opioid receptors unavailable (1). Even if the patient uses another opioid, the effects of that opioid will be significantly be reduced (1). 

Many people today in the area, including my husband, are on the suboxone treatment plan for opioid addiction. Our family has dealt with this recovery plan for over five years now. We understood it to be a long-term treatment plan but never knew it could also take the place of another addiction. On the website “Starting Point; Doesn’t Suboxone Just Replace One Drug for Another?”, it explains that there are pros and cons.  Suboxone is a drug and the use of it to help free the body of the need for opioid drugs such as prescription painkillers or heroin (“Suboxone Detox Program” 1). Though, because Suboxone is a partial opioid agonist, its unique features allow people to reduce or avoid withdrawal and cravings while at the same time largely blocking the effects of other opioids (1). Studies have shown that people taking Suboxone tend to better their chances of achievement with non-drug therapies. Suboxone patients usually are better able to focus on their counseling and recovery because they are not sidetracked by cravings and withdrawal symptoms (1). Handling the physical symptoms of the disease can allow people to gain control over their dependence (1).

Absurd
As a family we have seen whether this drug treatment has worked for my husband. We have watched my husband go from one addiction to another one. It has worked to keep him from opioids, but now he can’t live without the suboxone. It has now become an addiction. When we did not have medical insurance, the cost was over $1500.00 for one month’s dose. There were times we had to choose whether to pay our rent or pay for the suboxone. We lost many things and have had to move due because we couldn’t pay the rent just to keep my husband from have withdrawals. Many people today call suboxone a wonder drug. Many of the doctors that we have seen only see my husband for just a few minutes and do not require their patients to seek theory. These doctors also do not take insurance and are cash only.  This can be so costly for a family trying to take care of an addict.  From websites to paper pamphlets, suboxones seems to be a go- to for opioid addiction. The problem is the site will not inform people that they could become addicted to it or without insurance it is very costly. Due to the cost being so high and patients becoming addicted to suboxone, a black market for it has been seen in the past few years on the rise. There must be a batter way of treating opioid addiction because suboxone has only takin the place of opioids. One way is the government needs more regulations on this drug. Therapy needs to be more available for opioid addicted patents. There is an underline start for that addicting behavior and it should be more focused on. Going from taking one addiction and replacing it with another is not treating it, just coving it up and pharmacies companies are profiting from it.

For some their purpose for living or what motives them every day is now gone. The addiction is so powerful that it takes everything from the person like family, work, pride, faith, and even their health. All of this is no longer important to the person.  In most part, some of these people are living in cycles. Just as Camus states “Work-eat-love-sleep daily existence”. This is how some people with addiction see life as cycles, work more, to make more money, to buy more drugs, to be able to work more. It's so absurd to see someone live their life just for a drug, instead of things they love. To sit back and choose this drug above all the things; is just madness and meaningless. Our family watched my husband live this cycle.

Conclusion
 Dealing with this opioid epidemic in my family for so many years and still dealing with it today has changed our family so much. Throughout the years this epidemic has been on the rise. So many lives have either been changed and even lost. When a person becomes addicted to opioids, the addiction doesn’t just affect the addict but the people around them also. It's very hard to watch your love one chooses this addiction over you, your children, work, and even a roof over their head.  To think we have lost so much over a bad tooth. There are solutions to this opioid epidemic, but it will take everyone to help.
  


Work cited


 “Commonly Used Terms.” Center of Dieses Control and Prevention. https://www.cdc.gov/drugoverdose/epidemic/index.html
"HEAL Initiative Research Plan." National Institutes of Health (NIH), 18 Apr. 2019, www.nih.gov/research-training/medical-research-initiatives/heal-initiative/heal-initiative-research-plan.
“History of the Opioid Epidemic”. Foundations Recovery Network. https://www.dualdiagnosis.org/infographics/history-of-the-opioid-epidemic/
National Institute on Drug Abuse. "Opioid Overdose Crisis." National Institute on Drug Abuse (NIDA) |, 22 Jan. 2019, www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.
"Suboxone Detox Program." Starting Point Behavioral Healthcare | Starting Point Behavioral Healthcare, www.spbh.org/services/suboxone-detox-program/.
"Suboxone." AddictionCenter, www.addictioncenter.com/treatment/medications/suboxone/.
"Teenage Opioid Addiction." RehabSpot, www.rehabspot.com/opioids/who-addiction-affects/teenage-opioid-addiction/


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