Research: Getting at the ‘why’ in opioid epidemic

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A new group hopes to address increased opioid abuse in Kootenai County, according to Thursday’s Press. That begs a disturbing question. Why is prescription drug abuse so high?

The answers seem to be simple: Because it’s been too easy and too tempting.

According to the National Institute on Drug Abuse, opioid prescriptions dispensed by U.S. pharmacies tripled since the ’90s — from 76 million in 1991 to 219 million in 2011. Paralleling that was another near-tripling of opioid-related deaths and ER visits. Legal or illegal, these drugs are responsible for the majority of overdose deaths in the U.S. today.

Official responses. Federal and state governments, along with local agencies, have joined forces to curb this modern epidemic.

In 2011 and 2015, the White House initiated two cooperative strategies to educate health providers, pharmacists, patients, parents, and youth about the dangers of prescription drug abuse; implement effective prescription drug monitoring programs (if you’ve ever been told “no” on an early refill, that’s probably why); medication disposal and addiction reduction programs; and aggressive enforcement addressing doctor-shopping and pill mills.

Adult demographic. This isn’t a teen thing, at least not primarily. Prescription drug abuse can happen to anyone, but the NIDA reports a demographic profile of adults 23 and older, more rural/suburban, both men and women. While past demographics showed races equally represented in prescription opioid abuse, since 2004 nearly 90 percent are white.

Treatment is up, but not enough. According to NIDA, those receiving treatment for prescription opioid addiction rose from 360,000 in 2002, representing 10.3 percent of the total treatment population, to 772,000 or 18.6 percent in 2014.

Why they’re so addictive. Opioids — even prescribed for legitimate pain — are highly addictive, in large part because they stimulate powerful feel-good endorphins in the brain. Endorphins dull pain and boost pleasure (so the nation’s increased rates of depression aren’t helping matters). When the good feeling wears off, it’s tempting to want it back.

Over time, a user’s body produces fewer endorphins of its own, so that needy feeling, and how much drug it takes to produce the same effect, increase.

Risk factors. While literally anyone who takes opioids is at risk, according to the Mayo Clinic, length of time and other factors also play a role. Research indicates that addiction risk can increase after only five days of use.

Additional risk factors include poverty, unemployment, prior or family substance abuse history, relative youth, regular contact with high-risk people or environments, thrill-seeking behavior, tobacco use, stress, and history of severe depression or anxiety.

Physician, law enforcement, and legislative efforts are helping; opioid prescriptions declined 12 percent in 2017 — the biggest drop in 25 years, according to Healthanalytics.com. But synthetics and black-market supplies continue to drive opioid-related deaths, which are at an all-time high, along with the rising costs of opioid addictions.

Much work remains.

•••

Sholeh Patrick is a columnist with the Hagadone News Network. Contact: Sholeh@cdapress.com

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