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Why the Rampant Opioid Epidemic Is America's Worst Drug Crisis Ever

Opiates America is in grips of the deadliest drug crisis in its history, with opioid-related overdoses killing more Americans than gun homicides and car crashes combined. According to the National Institute on Drug Abuse, the escalating opioid epidemic, which has been largely caused by a dramatic spike in opioid-related overdose deaths and sadly experts believe hasn't even peaked yet, claimed the lives of more than 560,000 Americans between 1999 and 2015.

CDC data show that in 2015, more people lost their lives to drug overdoses than to HIV/AIDS at its infamous 1995 peak. Over 52,000 people succumbed to drug overdoses in the US that same year, and about two thirds of these deaths were linked to heroin and prescription opiates such as OxyContin, Percocet and the extremely potent fentanyl. The death toll of this rampant opioid epidemic exceeds the recent methadone epidemic, the crack epidemic and past heroin epidemic, and preliminary data from last year indicate that it may have gotten even worse since the previous year.

The US consumes more opioid pain relievers than any other nation in the world and white Americans die disproportionately from opioid-related overdoses. The devastating opioid epidemic has been mainly concentrated across areas such as New England and the Rust Belt, largely due to the massive number of prescription opioid pain relievers that clinicians wrote in these regions. In some states such as North Carolina, South Carolina, Ohio, Tennessee, West Virginia, Indiana, Missouri and Oklahoma, doctors have doled out more prescriptions for opioid painkillers than there are people, according to 2012 CDC data.

But according to a 2011 report from the Institute of Medicine, there was a pertinent reason for this overwhelming number of opioid prescriptions, as nearly 100 million people in the US suffer from chronic, debilitating pain. In 2012, US clinicians wrote a total of 259 million prescriptions for opioid painkillers. Ten states have now legislation limiting opioid painkiller prescriptions to 7 days or less.

Despite pharmaceutical companies' powerful marketing, there is not enough evidence to support the fact that opiate pain relievers can effectively treat chronic pain. On the other hand, there is plenty of scientific evidence suggesting that long-term use of these medications is associated with an increased risk of abuse, dependence, overdose and death. It also explains why Americans report greater levels of chronic pain, according to a health and retirement study (1998-2010), despite the huge increase in prescriptions for these drugs.

Anna Lembke, a Stanford psychiatrist and author of " Drug Dealer, MD" said there is a high likelihood that opioid painkillers would stop working after a month or two due to tolerance, thus leaving the patient with 2 major problems - their chronic pain and dependence on opioids, not to mention painful withdrawal. Prescription opioids can trick the patient into believing that they are very effective for their pain due to their chemical composition, when in fact evidence suggests that these medications can actually worsen chronic pain, as they increase sensitivity to pain and weaken the bones, making patients more prone to injuries. Lembke also explained that when a patient pops extra opiate painkillers they cannot hear the signals from their body telling them what they should not be doing.

To make matters even worse, the risk of continued opioid use increases at roughly 4 to 5 days, a recent CDC study says. Opioids prescribed for very long periods of time, just to be safe actually exacerbate the already devastating effects of the opioid epidemic, as the risk of getting hooked on these drugs dramatically increases each day a patient is prescribed these pain relievers. Anna Lembke added that older Americans in particular need to learn to accept the fact that there are some things they will not be able to do anymore, so they should not use opioids to extend their limits and keep doing the things they were doing in their 20s.

Opioid-related overdoses are one of the factors behind the recent decline in life expectancy.
According to the National Vital Statistics System, US life expectancy dropped from 78.9 years to 78.8 years in 2015, caused by the rise in drug overdoses and alcohol poisoning, among others. The last major decline occurred in 1993, when life expectancy in the US dropped by 0.3 years. The reality is that proper treatment for those struggling with an opioid use disorder still remains inaccessible to at least 89% of these people, as 2014 federal data suggest, without even considering homeless and incarcerated individuals. The reasons include lack of insurance or insurance that doesn't cover the entire treatment as well as insufficient space in specialized treatment centers where waiting lists are typically weeks to months-long.


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