[Note: This posting is a continuation of a report on
the development of a civics unit of study.
This unit is directing students to formulate informed positions on the
opioid epidemic. Presently, this
development, in real time, is reporting a set of factoids on the
responsibilities Americans bear for its tragic consequences.]
The last posting that addressed the opioid epidemic, July 13,
2018, a brief description was given on how modest amounts of abusing prescribed
doses of opioids can easily lead to addiction.
This posting will begin looking at the responsibility consumers of
opioids have in causing the accompanying epidemic. Central to understanding this addiction
problem is to gather a sense of its magnitude.
And this has led observers to the eyepopping numbers of people being
addicted.
A few of those numbers give one a
sense to the extent this epidemic has grown.
Initially, opioid consumption did not begin on its own impetus;
Americans did not wake up one morning and decide to take these drugs. Reacting to the reported incidence of chronic
pain in the late 1990s – in the neighborhood of 100 million people – both the drug
companies and the federal government began to encourage these afflicted people
to take painkilling opioids.[1]
To what degree? Here is part of the statistics: from 1991 to 2011 prescriptions rose from 76
million per year to 219 million and then to 289 million in the year 2016.[2]
As this volume
rose, the numbers of people being treated for substance abuse followed as well
as those of deaths due to opioid overdoses – as reported in previous postings. Not surprising given the fact that from 2002
to 2012 the rate of drug users being prescribed drugs more powerful than
morphine jumped from one-in-six drug users to one-in-three. Most common drugs prescribed were oxycodone
and hydrocodone.[3]
An angle to
this problem that has been given little attention is how Americans dispense
healthcare. This nation’s system often
leaves individuals to obtain private insurance and, in turn, these companies
heavily favor drug treatment over costly therapies. According to the expert, Judith Feinberg of
West Virginia University, “Most insurance, especially for poor people, won’t
pay for anything but a pill.”[4] This bias places the US with a 40 percent
higher rate of prescribing opioids than Germany or Canada.[5]
Another expert
from University of Utah, Josef Stehlik, chimes in:
Opioids are treated differently [in
the US]. First, there’s much less
prescription of opioid for pain in Europe, so there’s less chance of addiction
from people who started opioid use in a legal, medical way. Second, in many but not all European
countries, the rate of illicit opioid use is either stagnant or decreasing.[6]
And one can ask: does this prescription rate in the US lead to
less reported incidences of pain? Given
that with the increase of opioid prescriptions there has been a decrease in
non-opioid prescriptions, such as for aspirin or ibuprofen, has there been
noted change in reported pain? In the
US, the answer is no. This has caused
many to question the curative effectiveness of opioids.[7]
With these factoids established, one
can better answer the question with which this posting began: what is the responsibility of Americans in causing
the outbreak of this epidemic? This blog
will take up the rest of the answer in the next posting.
[1] “America’s Opioid Epidemic Is Worsening,” The Economist, March 6, 2017, accessed
July 19, 2018, https://www.economist.com/graphic-detail/2017/03/06/americas-opioid-epidemic-is-worsening
.
[2] “Opioid Epidemic,” Wikipedia, accessed July 18, 2018, https://en.wikipedia.org/wiki/Opioid_epidemic
.
[3] “America’s Opioid Epidemic Is Worsening,” The Economist. Of note:
oxycodone sells under the brand name OxyContin or Percocet and
hydrocodone under Vicodin.
[4] Owen Amos, “Why Opioids Are Such an American
Problem,” BBC, October 25, 2017,
accessed July 19, 2018, https://www.bbc.com/news/world-us-canada-41701718 .
[5] Amanda Erickson, “Opioid Abuse in the U. S. Is so Bad
It’s Lowering Life Expectancy: Why
Hasn’t the Epidemic Hit Other Countries?,”
Washington Post, December 28,
2017, accessed July 19, 2018, https://www.washingtonpost.com/news/worldviews/wp/2017/12/28/opioid-abuse-in-america-is-so-bad-its-lowering-our-life-expectancy-why-hasnt-the-epidemic-hit-other-countries/?utm_term=.c5d14bc5db2c
.
[6] Ed Cara, “The U. S. Opioid Crisis Is So Devasting, It’s
Made More Organ Available for Transplant,” Gizmodo, May 16, 2018, https://gizmodo.com/the-u-s-opioid-crisis-is-so-devastating-its-made-more-1826053571
.
[7] Matthew Daubresse, Hsien-Yen Chang, Yuping Yu, and George
Caleb Alexander, “Ambulatory Diagnosis and Treatment of Non-Malignant Pain in
the United States, 2000-2010,” Medical Care, vol. 51, no. 10, October, 2013,
accessed July 19, 2018, https://www.researchgate.net/publication/256500618_Ambulatory_Diagnosis_and_Treatment_of_Non-Malignant_Pain_in_the_United_States_2000-2010
, AND Robert Gebolhoff, “The Opioid Epidemic Could Turn into a Pandemic If
We’re Not Careful,” Washington Post,
February 9, 2017 AND “Facing Addiction in America,” U. S. Surgeon General
(SurgeonGeneral.com), 2016, site page no longer posted, see
https://addiction.surgeongeneral.gov/executive-summary . Reported decreases of prescribed non-opioids
range from 38% to 29%.
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