An epidemic is the rapid spread of something throughout a given population. The term is usually used like the word outbreak and both are mostly used to refer to diseases. You hear things such as a cholera outbreak or a typhoid epidemic all the time. These aren’t to be confused with the term endemic which means that a disease is constantly present within a given population.
An epidemic doesn’t always mean a bad thing as it’s sometimes used to describe the spread of something like a fashion or a trend. Unfortunately America isn’t suffering from the good kind of epidemics these days. The United States and North America in general are facing an opioid epidemic. If you’re unfamiliar with the term opioids it’s basically a class of drugs or chemicals which includes Oxycontin, Percocet, and Percodan. These drugs are sometimes prescribed in hospitals for patients who are in severe pain. They alleviate the pain and unfortunately are being used illegally as recreational drugs. Opioids are different from opiates. Opiates are more easily manufactured from opium plants and include morphine, heroin, and codeine.
This epidemic has many consequences which mainly revolve around the health of the population consuming them. The use of opiates and opioids, and drugs in general, can also lead to many crimes. There are also financial consequences to the drug trade.
Both opioids and opiates work through the same mechanism. They attach to receptors in the body and these receptors have effects on the cells they’re attached to. Opioid receptors are mostly found in the brain and spinal cord which explains why they’re so potent when it comes to treating pain. Through the action completed by the opioid receptors nerve cells transmit and sense pain differently which results in decreased pain sensation. If you’re not someone who suffers from pain, however; then these drugs will enhance your experience of pleasure through relaxation and elation. They sound good now but they can actually kill and lead to addiction but we’ll get to that in a little bit.
Like we said opiates are the more well known and are easily made from opium plants. We’ve all heard of morphine and heroin. Opioids are made in labs mostly by pharmaceutical companies in order to be used in hospitals and to be prescribed by licensed physicians.
The intake of these drugs can lead to serious addiction even from very little or recreational use. It’s easy to constantly want the feelings of elation and pleasure they provide you with. However, with prolonged use of these drugs something called down regulation happens to the opiate receptors. This means that the receptors decrease in number as a result of being over stimulated. When the number of receptors decreases you’re going to need higher doses of opium in order to reach the level of satisfaction you want and are used to. With time you’re going to need higher and higher doses. At some point the purpose of one’s life will be acquiring and taking opioids or opiates. This can result in relationship difficulties, financial issues, and even criminal behavior.
If a person uses opiates intravenously through injections and shares needles with others they can end up acquiring blood borne infections such as hepatitis B, hepatitis C, and HIV. Opiates and opioids are also respiratory center depressants meaning they can inhibit the act of respiration. In large doses this effect can be potent and so strong that a person stops breathing and dies.
Unfortunately North America and the United States are currently suffering from a very serious opioid epidemic. Over 20 million Americans are suffering from addiction. In Canada nearly 2,500 people have died of an opioid overdose over the last year. Canada’s health minister has said this is higher than any infectious epidemic the country has witnessed.
The epidemic has hit West Virginia hard. 84% of West Virginians say that prescription pain medication abuse is the major health problem in the state. 71% of them know someone who experienced severe pain to the extent that they sought prescription pain killers to treat it.
In the United States the Drug Enforcement Administration have said that by 2015 the number of deaths from overdose have surpassed deaths from both guns and car accidents. Drug overdoses are now the leading cause of death in those under the age of 50 in America. Over 60% of these drug overdose deaths are due to opioids. This year (2017) a state of emergency has been declared in Maryland to combat the epidemic. In July of this year the opioid epidemic was declared the FDA’s biggest crisis.
One alternative to patients with chronic pain is physical therapy. Physical therapy is a much safer and improved option when compared to the use of pain killers. Pain medication will only terminate the pain for a while. When the drug wears off the pain returns and the patient will require more drugs. Physical therapy offers a lot more. Through physical therapy people can learn how to actually manage their pain when it comes to their day to day lives. If you have joint pain your physical therapist will show you how to support the joint better through muscle strengthening and will also show you how to improve your range of motion giving you more flexibility and freedom of movement. You’ll also be shown what can increase the pain and how to avoid it. Overall this teaches you how to control and manage the pain and not simply hide it for a few hours.
The CDC recommends that patients with chronic pain use nonopioid therapies. On the long run opioids will damage a person’s health and will not lead to improvement of the condition. The risks of opioids definitely outweigh the benefits. Physical therapy offers so much more and anyone who has the option of physical therapy should definitely opt for it over the endless use of opioids and other pain killers.
Do doctors have a role in this epidemic? They probably do. Maybe the use of painkillers is easier and so is prescribed by doctors more often. If unsupervised, this will lead to a patient’s addiction and potential overdose. Perhaps for acute conditions such as a kidney stone it would be appropriate to use a painkiller as it’s a onetime thing and the stone will pass in a few hours. After that the patient will have no need for the painkillers. On the other hand patients with chronic pain should be advised to seek physical therapy. As physicians the main target of management should not be to hide the symptoms but to improve the patient’s quality of life. Opioids have no positive impact on someone’s life; on the contrary they have a detrimental one.
Doctors together with physiotherapists should form a plan that works best for each patient. It will take a little time but eventually the patient will feel much better and thank you for your efforts. If physiotherapy is not a treatment option and a patient will unfortunately have to rely on opioids then it’s very important to warn them about the potential side effects and that they can cause death through respiratory depression. On the long run you can monitor your patient’s status for any signs of addiction or dependence. You can also pay attention how often they come looking for a refill. If you realize a patient is starting to develop dependence then the best option would be to help them get over their addiction and potentially seek additional help.
Painkillers are no joke and they need to be taken very seriously and handled with care. Patients should be monitored and any illegal way of acquiring the drugs should be shut down. A country with an opioid epidemic will lose its young population and suffer in so many ways on the long run. That’s why controlling and completely terminating this epidemic should be an absolute priority not just for the government, but also for healthcare workers and every single citizen.