opioid epidemic

The Opioid Epidemic
Student’s Name
Institution
Abstract
The continuous usage of opioids in the treatment of chronic pain in non-cancer and cancer patients has continued to increase over the past few years. Various associations such as the American Pain Society, American Academy of pain medication, have attempted to commission a systematic review of the evidence supporting opioid therapies while multidisciplinary experts have reviewed the outcomes of the medication use on various patients. The use of this drug in nonmedical prescriptions has also been singled out within the settings outside the medical fields to be a cause of the rise of mortality. The abuse of opioids as prescription medication, consequently, has resulted in critical health problems amongst patients and an estimated fifty million individuals have used opioids to relieved pain for medical reasons. This paper evaluates the use of opioids as well as its relation to the mortality rates of patients within the medical settings. This relationship is also assessed based on the risk occurrence of the drugs overdose leading to the death of patients.
The Opioid Epidemic within the Clinical Settings
Introduction
The opioid drugs are often referred as illegal due to the heroin component found in their compound. There are various synthetic opioids which include Fentanyl and other pain relief medication offered legally through a medical subscription. Examples of these prescriptions include oxycodone and hydrocodone. Codeine and morphine are other prescriptions regarded as opioids.

Regarding the psychological perspectives, the elderly has become quite susceptible concerning the ongoing rise in complications that are well associated with alterations. These alterations have more to do with the late diagnosis of various ailments and pharmacokinetics. The diseases, in this case, include the viral hepatitis C. The continuous promotion of health for these populations has become imperative regarding the treatments and prevention strategies of the addition of opioid.
Problem Statement
Over the past few years, the existent rate of prescription of the related opioid drugs has increased within the united states (Jones et al., 2010). This paper thereby seeks to determine the interrelationship of the daily prescription medication of opioids and the risk of intentional and unintentional overdosage of the drug. The opioid epidemic has become a challenge in the united states region and has impacted several age groups. The elderly populations have seldom discussed the short and long-term effects of the usage of opioids (National Institute on Drug Abuse, 2011).
In response to the epidemic of opioids usage, there a various government and non-government organisations that have issued prescription guidelines regarding the case (Chou et al., 2009). These guidelines have the purpose of reducing the numbers of opioids prescriptions hence the diversion of the drug misuse. Responding to these actions had required guidelines that protect the appropriate use of the drug. Some of these guidelines also fail to cater for the patients in the palliative care systems programs and the cancer patients as well. They also fail to replace medical judgements of the individual care of the suffering patients (Health JDO, 2009).
Purpose of the Study
The purpose of this study was the determination of the association between the prescription of opioids and their overdosage that relate to deaths. This factor is concerning the patterns of the drug prescription. This study includes an estimated 155434 patients who were the treatment of opioids through the VHA for measurability purposes. The drugs that were prescribed regarding this study include Hydromorphone, codeine, Oxycodone, and hydrocodone.
Hypotheses of the Study
The relationship between the increments of opioid dosage directly leads to the occurrence of the drug overdose.
The risk occurrence of deaths among the patients suffering from chronic pain is directly related to the use of the opioids in their prescriptions leading to the occurrence of overdosage.
The regulation of opioid use has resulted in the decrease of mortalities regarding the patients on opioids prescriptions.
Literature Review
Various studies have revealed that an estimated 1.8 million patients have met the criterion of the drug’s prescription due to the occurrence of chronic pain (Bohnert et al., 2011). A random sample of these individuals has also revealed that an estimated 154684 patient’s records with regards to the utilisation of the drug. Among these patients, an estimated 1136 individuals died due to the prescription of the drug overdose. More so, 752 of the patients in the studies indicated treatment of their ailment with the drug for their chronic pains. Therefore, there exists a vivid interrelation of the use of opioids and overdosage. The drugs that were observed include codeine, morphine, hydromorphone, hydrocodone, and oxycodone.
The past decade timeline of 1999-2007 also encompasses an increase in death rates due to the accidental overdosage of the drug by a 124% increase (Bohnert et al., 2011). This factor was related to the increment in the overall prescription of the drug. To gain a deeper comprehension of the factors that have led to this increase in the prescription of the drug had provided strategies that can be used in the decrement of mortality rates of the patients whose subscriptions entail the use of opioids. The increase in the risk occurrence of a drug overdose, in this case, is more susceptible to the patients with chronic pain. This factor fails to relate to the cancer patients (Edlund et al., 2009). There exists a diversity of the treatments that involve the use of opioids. The levels of pain have more to do with this factor such that the maximum number of opioids used on these patients are not often similar. This same study indicated a correlation between the risks of overdosing medical patients with the opioid medications and the maximum prescriptions of the medications with the compounds of the drug. Over a five-year period of examination, the patients who were discovered to have been taking opioids during their treatment from the VHA as non-cancer patients, and the cancer patients, were under observation with regards to the impacts of the drug. Other subgroups were further involved in the study and had acute pain and a substance abuse disorder. The data collection was a record of the first time these patients received their dose of opioids to the time if deaths occurred.
Out of the 1136 individual patients who died due to the overdose of the drug, 752 patients had been under the treatment of chronic pain which resulted in overdosage. The prescriptions handed to the medical practitioners were mostly accidental overdoses. This factor applied to both cancer patients and the non-cancer patients. In the cancer group, the maximum dosage had been reached which led to an accidental overdosage that was twelve times more likely in occurrence. The chronic pain non-cancer group, on the other hand, had seven times more likelihood of accidental overdosage. In both groups, the patient with a lower risk of overdose that could have resulted in death was a ratio of 1 to those whose dosage was less than 20g of the opioids.
Another study indicated similar results regarding the use of opioids during patient treatment. The findings were that the risk occurrence of overdosage regarding accidental cases was higher as more of the prescriptions were handed out to the patients. This study, however, only included that cancer patients who were treating chronic pain. Numerous factors were also found to impact the results of these studies. For instance, the patients could obtain the opioids from non-VHA sources as well as outside the clinical settings. The patients in some cases could further obtain the opioids as medication and save them later for recreational purposes. The study was, however, unable to gauge the actual dosages that were taken by the patients hence only the prescribed dosages were in the study records.
The opioid prescriptions of the dosage of the drug have increased in the united states from 120 to 210 million, and various evidence has suggested that this increase directly contributes to the total number of opioids casualties (Volkow et al., 2009). The opioids ought not to be considered as a primary approach to the management f pain. Through recognising the inherent risk occurrences, various alternatives can impact the pharmaceutical interventions for the treatment of acute pains. The pharma logical interventions include therapies that cater to the fractured immobilisations as well as the appropriate elevation of symptoms in the injured patients. There are types of opioids that can be considered as adjunctions to the acute relieving pain and include the immediate release of oxycodone and hydromorphone (Volkow et al., 2009).
More so, the higher doses of opioid medications as well as the prolonged medication cases do increase the risk occurrences of overdosage (CDC, 2011). Patients should be involved in the therapeutic treatment of probable opioid addiction regarding the long-term patients.
Consequently, the increased doses administered to the patients have been found to higher the risk of overdosage. Once the drug is prescribed, the patients ought to receive that adequate amounts of the dose from the emergency departments such that these doses last them to their consultancy stages. The further assessment of the patient’s pains ought to be followed up by the appropriate treatments thereby minimising the use of the opioids (Dowell, 2012). In the cases where the patients are in pain that has outlasted the initial drug prescription, that medical evaluation of the involved condition scan is warranted to exclude complexities of their pain treatments.
Hospitals are also meant to provide accurate medical screenings that assist in the determination of the patient’s emergencies and medical states (Smith et al., 2010). This provision is required by the law although it fails to require that the physicians use the opioid analgesic in the treatment of pain.
Theoretical Framework
The Roy adaptation theory presents an individual’s system of adaptation with the constant interaction of a given factor. The individual, in this case, is found to be in a constant interaction with a given factor in their environment which can be referred to as stressors. The human system is also tasked with the maintenance of the integral values despite the environmental stimuli. This interaction often results in the outcomes that generate conscious awareness. Adaptations on the other hand yield the promotion of optimal health as well as smoother integration to the environment. In other cases, the adaptation could lead to quality of life or otherwise dignified deaths. This adaptation levels are integrated, compensated and also comprised of life ling processes. Integration of the comprised life processes can alter in a compensatory state for re-establishing adaptations. The involved processes of coping with the adaptation can fall into categories that regulate the individual subsystems of cognition. The perceptual information processes require the selective attention of the individuals which cater for the solution of given challenges.
Relating this theory to the case of opioid use amongst patients has to do with the exposure to the drug as an option. This factor then leads to different usage of the drug that has led to several outcomes. It would be flung off to obscure the successful results of the drug use amongst the patients suffering from chronic pain. However, the difference in the required levels of prescriptions has become stressors. Maintaining the integral values despite the need for the usage of the drug thereby becomes a complex process although still generating the conscious awareness of its impact in the mortality levels of the involved patients (Franklin et al., 2012). According to the theory, numerous adaptations have arisen due to the disparity of the use of opioids for the sole purpose of minimising the case of death casualties.
References
(CDC) Centers for Disease Control and Prevention. (2011). Vital signs: overdoses of prescription opioid pain relievers- United States. MMWR Morb Mortal Wkly Rep 60(43):1487–92.
Bohnert ASB, Valenstein M, Bair MJ, et al. (2011). Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA 305(13):1315–21.
Chou R, Fanciullo GJ, Fine PG, et al. (2009). Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. The Journal of Pain 10(2):113– 22.
Dowell D. (2012). New York City Emergency Department. Discharge Opioid Prescribing Guidelines.1–8.
Edlund MJ, Martin BC, DeVries A, Fan M-Y, Braden JB, Sullivan MD. (2009). Trends in use of opioids for chronic noncancer pain among individuals with mental health and substance use disorders: the TROUP study. Clin J Pain;26(1):1–8.
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Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. (2010). A single-question screening test for drug use in primary care. Arch Intern Med170(13):1155–60.
Volkow ND, McLellan TA, Cotto JH, Karithanom M, Weiss SRB. (2011). Characteristics of opioid prescriptions in 2009. JAMA 305(13):1299–301.