Introduction
In health care management, pain remains one of the key challenges despite the emerging evidence that provides a deeper understanding of its pathophysiology. Opioids have been used for several centuries to manage acute and chronic pain in patients, but there is an alarming concern about the growing opioid misuse. In the US, a lack of proper pain management, documentation, and pharmacological marketing leads to millions of deaths related to opioid abuse. This paper aims to research the identified topic, focusing on the reasons that create the epidemic and presenting the perspectives that can be used in combating it.
Reasons and Perspectives of Pain Management Abuse and Opioids
Statistics
The opioid overdose epidemic in the US is an increasing health care concern since it remains an acute problem that needs a multifaceted approach. As reported by the Centers for Disease Control and Prevention (CDC) (2022), overdose deaths increased by 30% from 2019 to 2020. At the same time, “nearly 75% of the 91,799 drug overdose deaths in 2020 involved an opioid” (CDC, 2022). This epidemic began in the 1990s with the vast prescription of opioid drugs for patients experiencing pain.
The second wave occurred in 2010, when heroin overdoses and deaths significantly increased. Furthermore, the US faced the third wave that was characterized by illicitly manufactured fentanyl overdoses and deaths (CDC, 2022). Today, the outbreaks of opioid abuse continue to be a challenge for the entire health care system, as it requires economic, political, and social attention from the public.
Causes and Factors
The main problem regarding pain management abuse and opioids refers to the need to balance between proper opioid prescription for treating pain and avoiding opioid overdose, misuse, and dependency. On the one hand, care providers fail to prescribe adequate doses of oxycodone, morphine, or other opioids, depending on a patient’s disease, sensitivity level, associated family issues, psychological state, and many other factors (Paice, 2018). Without proper treatment, chronic pain compromises one’s relationships, work, sleep, and overall well-being.
On the other hand, people may take their prescribed drugs in a dose or a way other than they are supposed to, or use someone’s medicine to achieve the effect of getting high. Bruera and Del Fabbro (2018) report that of all patients who need pain management, about 20% are at risk of the above complications. The problem involves complex relationships between caregivers and patients and health care system errors.
Speaking about pain management abuse, it is critical to mention that a range of factors deteriorate the given problem. Alcoholism and smoking are the two most aggravating factors mentioned in recent studies. According to Bruera and Del Fabbro (2018), about 17% of people with advanced cancer they have reviewed were at risk of developing alcohol dependency.
In addition, the respondents who had a status of current smokers showed that 42% of them were likely to be diagnosed with drug use disorder (Bruera & Del Fabbro, 2018). A lack of appropriate documentation makes the problem even more complicated since patients’ diagnostics and treatment remain without proper analysis. Pain management becomes a challenge in this connection, as it requires adopting various diagnostic approaches and using, for example, electronic medical records.
On a larger scale, opioid misuse by both caregivers and patients refers to the fact that large pharmaceutical companies aggressively marketed opioid painkillers, making millions of people dependent on these types of drugs. After becoming addicted to opioids, people began to switch to heroin, methadone, and other potent opioids even when their pain was not severe. As a result, statistics show that in 2020, 70,000 people died from an overdose of opioids, and 75% of people who take heroin in America became addicted after being prescribed an opioid painkiller (Paice, 2018). As a result, the economic cost of the nation’s epidemic of opioid addiction and overdose cost the country nearly $1.5 trillion in 2020, and that figure is expected to rise (Bruera & Del Fabbro, 2018). Therefore, it becomes clear that an elaborate call to action is necessary to improve pain management initiatives.
Administrative Response
The research on the given problem shows that official agencies, companies, and people know its critical nature. To combat the epidemic, the CDC (2022) elaborated an Overdose Data to Action (OD2A) that provides “timelier tracking of nonfatal and fatal drug overdoses, improving toxicology to track polysubstance-involved deaths better”. In addition, the OD2A is supposed to create programs for prescription drug monitoring, collaborate with public safety agencies, and innovate prevention activities.
It seems to be especially important to develop the links between national and local agencies since the latter are more aware of the unique needs of their populations (Paice, 2018). To ensure these collaborations, there is a need to support providers, payers, and care systems by equipping them with timely data, tools, guides, and evidence-based decision-making instructions. Significant attention should be paid to increasing public awareness so that people can have more opportunities to make safe choices regarding pain and opioid drugs.
Conclusion
To conclude, the opioid crisis is an acute social problem that began to manifest in the 1990s and continues today. A lack of proper pain management leads to opioid overdose, addiction, and illegal use, which causes millions of deaths and sets an additional economic burden on the health care system. Among the reasons for pain management abuse are inappropriate opioid prescription, poor documentation, aggressive marketing from pharmaceutical companies, and increased pain of various types in patients.
Research shows that a multifaceted approach is necessary to improve the current situation. The Overdose Data to Action (OD2A), increasing public awareness, and collaborations between national and local agencies can be noted among possible strategies. These initiatives are devoted to developing safer and modified prescribing practices and patient education. It is not possible to eliminate opioid drug use since many patients need to treat their pain. However, the existing opioid crisis should be addressed to save millions of lives.
References
Bruera, E., & Del Fabbro, E. (2018). Pain management in the era of the opioid crisis. American Society of Clinical Oncology, 38, 807-812.
CDC. (2022). Understanding the opioid overdose epidemic.
Paice, J. A. (2018). Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management. Cancer, 124(12), 2491-2497.