In the United States, approximately 11% of adults experience daily pain. Millions of Americans are treated with prescription opioids (a class of drugs that include heroin, as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, and fentanyl) for both acute and chronic pain. However, as many as 1 in 4 people prescribed opioid painkillers struggle with addiction to them.
More than 90 Americans die from an opioid overdose each day. Last year, 64,000 Americans died from a drug overdose, making overdose the leading cause of accidental death nationwide. Of these deaths, about 75% were attributed to opioid overdoses. Drug overdoses have become the leading cause of deaths for Americans under age 50, two-thirds of which are due to opioid overdoses.
The opioid crisis has become the biggest drug crisis in the history of America, and one so serious that it has been declared a public health emergency. With all eyes to how this epidemic will develop in the future, we begin to look to solutions that can be implemented to help reduce the risk of opioid addiction today.
How the Opioid Crisis Began
In the late 1990s, opioids became the most commonly prescribed type of drug for pain management. Pharmaceutical companies pushed inaccurate messaging on the safety and non-addictive nature of the opioid painkillers, and practitioners began prescribing them at increasingly more rapid rates. Misuse became even more widespread as illicit drug trafficking followed suit, making opioid drugs like heroin and fentanyl more accessible, and an option for people when they ran out of their prescribed painkillers.
The Magnitude of the Opioid Public Health Crisis
More than 300,000 Americans have lost their lives from opioid overdoses since 2000, and a forecast by STAT estimates that if action against the epidemic is not taken, over 500,000 people could die within the next 10 years. According to the American Society of Addiction Medicine, in 2015:
- Almost 21 million Americans over 12 years old had a substance use disorder, 2 million of which involved prescription pain relievers
- 591,000 Americans had a substance use disorder involving heroin
- 122,000 adolescents had an addiction to prescription pain relievers
- 21,000 adolescents used heroin
- Of the 33,000 reported deaths due to an opioid overdose, approximately two-thirds of those were attributed to overdose on prescription painkillers
In addition to adolescents, women are particularly at risk. Not only are women more likely to suffer from chronic pain than men, but evidence also indicates they also may become dependent on prescription pain relievers more quickly than men.
During this public health emergency, it is vital that clinicians properly educate their patients on the risks of taking opioids, should opioids be deemed to be the most effective treatment option. Opioids are considered safe if prescribed by a doctor and taken for a short period of time. It is crucial that doctors carefully monitor patients taking prescribed opioids to reduce the risk of patient dependence and abuse, and overdose related deaths.
When a patient is prescribed opioids, they should make sure that their practitioner:
- Explains the expected benefits and risks of opioids
- Emphasizes improvement in function as a primary goal, even when pain is still present
- Discusses serious and common side effects of opioids, such as constipation, dry mouth, nausea, vomiting, drowsiness, confusion, physical dependence, and withdrawal symptoms
- Advises the patient not to operate heavy machinery when taking opioids
- Discusses risks to household members and other individuals if opioids are intentionally or unintentionally shared with others for whom they are not prescribed
- Discusses the importance of periodic reassessment for therapy goals and opportunities to discontinue opioids
How healthcare technology can improve the opioid crisis
Combating substance abuse problems necessitates appropriate treatment, in the form of medication, rehabilitation programs, and psychological guidance. The White House released a declaration in October this year allowing for increased utilization of telemedicine services, including remote prescribing of medicines used to treat substance abuse. Telemedicine can greatly benefit a patient through:
- Increased access to care teams for the patient
- Reduced commute times
- Improved patient monitoring and access to patient care plans
- Improved response times when emergency issues arise
- Improved data capturing and reduced dosage errors with remote electronic prescribing
Beyond tackling the current opioid crisis, it is essential that medical providers offer a wider selection of treatment options to relieve acute and chronic pain. Telemedicine and digital health, including the use of remote electronic prescriptions, smartphone pain and addiction apps, and wearables can be key interventions to help tighten pain management regulations. Here at HealthTap, we are dedicated to using our virtual care platform as a tool to help spread awareness of and combat the growth of the opioid epidemic.
Authors: Simitha Singh Rambiritch and Maggie Harriman