STONE: Together we can fight opioid problem

Aside from being known celebrities, Heath Ledger, Prince, Chris Farley, Paul Gray and Tom Petty also had something else in common. Each died far too soon due to an ever-growing epidemic that continues to plague our nation. However, this particular epidemic is taking more than just the lives of musicians, actors and athletes. Opioid overdoses are becoming more and more prevalent with each passing year, and with no regard for whom they kill. Opioids are powerful pain-reducing medications that also include prescription oxycodone, hydrocodone, methadone and morphine to name a few. From carpooling soccer moms and retired teachers to college students and business professionals, deaths from overdosing (whether intentional or unintentional) have been on the rise.

The increase in opioid related deaths have certainly drawn much needed awareness to the issue, but the harsh reality is that this has been the epicenter of America’s drug abuse crisis for quite some time. Opioid medications have a knack for being somewhat surreptitious by having addictive qualities tied to them. According to the Centers for Disease Control and Prevention, drug overdose is the leading cause of accidental death in the U.S., with 52,404 drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 deaths related to heroin in 2015.

Patients who are prescribed these medications, whether to address pain after surgery or to manage chronic pain from a previous injury, do so with the mindset of not needing them long term. However, many of these patients too often fall into a percentage of people finding a dependence on these medications which turns into the darkness of addiction. The ripple effect of one opioid prescription can cascade into wave of unintended drug abuse. Even though prescription opioids are initially obtained legally, once that supply runs out the craving remains, leading people to obtain them illegally, or worse, seek illicit sources to satisfy their addiction. Often, the transition from legally prescribed opioids switches to heroin (a very powerful opioid as well) creating yet another pathway for chemical dependence and abuse.

Large scale agencies and clinicians have been faced to rethink policies and practices in an attempt to gain control of this problem. Four major components of these plans center on education, monitoring, proper medication disposal and enforcement. Key strategies include changing the way opioid medications are prescribed. This includes establishing a seven day limit for initial opioid prescriptions and ordering them electronically, instead of writing out standard “paper” scripts. Electronic ordering allows for better tracking, accurate prescribing and reduced errors. Additionally, practitioners can do more by exploring opioid treatment alternatives, lowering dosages as well as the number of extended-release pills prescribed, imposing closer oversight on prescription drug-monitoring data, expanding drug disposal programs and bolstering community-backed medication-assisted treatment programs.

Medical care is based on science and outcomes. Using these principles, it helps medical professionals re-think the management of pain. One promising practice on the rise is known as multimodal pain management. Multimodal pain management, endorsed by the likes of such organizations as the American Society of Anesthesiologists, Society of Critical Care Medicine, American Academy of Orthopedic Surgeons, and American Society of Pain Management Nursing, shifts the focus away from using opioid medications the primary treatment of pain by using a combination of medications to address different mechanisms of what triggers the response of pain within the body. For example, a combination of an analgesic to treat overall mild to moderate pain, an anesthetic (numbing agent) to the localized area of pain (such as an incision), an anticonvulsant to treat nerve pain, and a non-steroidal anti-inflammatory agent to address muscle/skeletal pain tackles the multiple facets of overall pain. The best thing is, these medications do not have the addictive qualities as opioids have. Lessening the risks of addiction improves overall outcomes, even after the patient has discharged home from the hospital or clinic.

Aside from much needed changes to once standard medical practices, breaking the opioid cycle also relies on public support.

What you can do to prevent the cycle of abuse, misuse, and overdose:

DO NOT take opioids in greater amounts or more often than prescribed.

DO NOT take opioids in combination with other medications such as benzodiazepines (such as Xanax, Valium), muscle relaxants (such as Flexeril, Soma), hypnotics (such as Ambien, Lunesta) or other opioid medications.

Dispose of any unused opioid medications.

DO NOT give unused opioid medications to others, even if that person has a prescription for the same (or similar medications).

Work with your doctor on creating a plan to manage pain that do not include opioids.

If you or a loved one are having a surgery or procedure, talk to your physician about multimodal pain management strategies ahead of time.

ALWAYS follow up with your healthcare provider regularly.

This epidemic is prevalent in all facets of our society. Unity and determination, amongst us all, is what it will take to win this battle. Let’s do our part to protect not only those we love, but to ensure a safer generation for those to come.