opoidoverdose

[opoidoverdose]

Opioid Overdose Epidemic in the United States

Overdoses associated with opioids in the United States killed nearly 50,000 people in 2019. There is a serious national crisis of prescription pain reliever misuse and addiction, heroin addiction and synthetic opioid use such as fentanyl, leading to harm to the public health, economic welfare, and social welfare. A study conducted by the Centers for Disease Control and Prevention calculated that the "economic burden" of prescription opioid abuse alone in the United States exceeds $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

Death can result from opioid use because it affects the part of the brain that regulates breathing. A person experiencing an opioid overdose may exhibit a combination of three signs and symptoms: (1) pinpoint pupils; (2) unconsciousness; and (3) difficulties with breathing.

The use of drugs kills approximately 0.5 million people worldwide every year. Nearly 70% of these deaths occur as a result of opioid use, and more than 30% of them occur as a result of overdose. According to estimates by the WHO, approximately 115,000 people died of opioid overdoses in 2017. Overdoses with opioids that do not result in death are several times more common than fatal overdoses.

Several countries have seen an increase in opioid overdoses in recent years, partly because opioids have become increasingly used in treating chronic pain, and becoming increasingly available in illicit drug markets. Overdose deaths from opioid overdose have increased by 120% in the United States between 2010 and 2018. Over half of those opioid-related overdose deaths were from synthetic opioids – including fentanyl and its analogues.

Fentanyl is a powerful synthetic opioid that can be used both as pain reliever and anaesthetic. This drug is approximately 50-100 times stronger than morphine. Different formulations of Fentanyl is part of the WHO Model List of Essential Medicines. Fentanyl and its analogues (including carfentanil, acetylfentanyl, butyrfentanyl, and furanyl fentanyl) have been linked to a spike in deaths from opioid overdose. A recent study examined fentanyl distribution patterns in the United States. There is evidence that drug dealers may add fentanyl to increase the potency of their products (such as heroin) and sell it as counterfeit tablets that look just like the authentic prescription medications. Because of this, many users who test positive for fentanyl and its analogues do not realize that they have been using the drug.

What factors are associated with overdose on opioids? An overdose is linked to a number of risk factors. These include:  

* having an opioid use disorder;

*taking opioids by injection;

*resumption of opioid use after an extended period of abstinence (e.g. following detoxification, release from incarceration, cessation of treatment);

*using prescription opioids without medical supervision;

*high prescribed dosage of opioids (more than 100 mg of morphine or equivalent daily).

*using opioids in combination with alcohol and/or other substances or medicines that suppress respiratory function such as benzodiazepines, barbiturates, anesthetics or some pain medications; and

*having concurrent medical conditions such as HIV, liver or lung disease or mental health conditions.

What are the emergency responses to overdoses of opioids?

Death due to opioid overdose is preventable if the individual receives basic life support and the administered naloxone treatment at the right time. Taking Naloxone (the antidote of opioids) when an opioid overdose has occurred will reverse the effects completely, as long as it is administered in time. If someone has not taken opioids before, Naloxone has practically no effect.

Generally, health professionals are the only ones with access to naloxone. Although naloxone is widely available in many countries, there is still limited availability in medical settings, including ambulances. Meanwhile, some countries already sell naloxone in pharmacies without prescription. A number of countries, including Australia, Canada, Italy, the UK and Ukraine, have recently approved naloxone as an over-the-counter medication for drug addiction and encouraged proactive distribution within their communities.

In previous years, a number of programs around the world have shown that providing naloxone to individuals likely to witness an opioid overdose, in combination with training on the use of naloxone and on the resuscitation of people following an opioid overdose, could substantially decrease the number of deaths resulting from opioid overdose. This is especially relevant for people becoming free from prison, as they have an extremely high rate of opioid overdose in the four weeks following their release.

An overdose from opioids can be difficult to recognize. The best thing to do if you're not sure is treat the situation as though it's an overdose so you could save someone's life. Do not leave the individual alone. Call or seek medical assistance immediately.

In order to protect the public from opioid overdose deaths, effective opioid prescribing should be improved, acute exposure to opioids should be reduced, misuse should be prevented, and opioid use disorders should be treated.