Introduction
Opioids have been used by humanity for a long time, mainly for the treatment of pain, spiritual, and recreational purposes. Nowadays, they are commonly used in medicine, primarily for the management of cancer, acute, and chronic pain. Even though there are benefits of opioid therapy, there are also numerous side effects of this type of treatment. The easy availability of opioid medications has had severe adverse consequences for the US citizens, especially for New Jersey’s population. The purpose of this essay is to consider New Jersey’s opioid crisis from the perspective of its relationship with opioid therapy and examine both benefits and risks of this kind of treatment.
New Jersey’ Opioid Crisis as a Part of the US Opioid Epidemic
There is a significant increase in opioid addiction and death in New Jersey. New Jersey’s opioid crisis can be considered as a part of the US present-day opioid epidemic. One of the most significant causes of the spread of the disease is the production and prescription of opioid painkillers. The national crisis began in the 1990s when pharmaceutical companies marketed new drugs and claimed that they were non-addictive (DeWeerdt, 2019). The marketing resulted in a sharp increase in the availability of the pharmaceutical narcotics, and the medications quickly became popular substances for the management of chronic pain. Despite the claim that the new opioid painkillers were less addictive, many people, who had been prescribed the drugs, moved from legitimate use to dependent and then abused one.
For example, one of the pharmaceutical companies, Purdue Pharma, introduced a painkiller called OxyContin (a formulation of oxycodone) in the 1990s. The company convinced doctors that the drug was safe, effective. and non-addictive. However, it turned out that the drug caused dependence. As a result, there was a steep rise in people addicted to OxyContin in the US. According to Higham, Horwitz and Rich (2019), “the volume of the pills handled by the companies skyrocketed as the epidemic surged, increasing about 51 percent from 8.4 billion in 2006 to 12.6 billion in 2012.” Later, Purdue Pharma, declared that its statement the OxyContin’s safety was wrong, but it was too late.
The prescription of opioid painkillers has exploded dramatically since the 1990s. Nowadays, the US is one of the two largest consumers of opioids worldwide (Kim, Nolan, & Ti, 2017). According to Rose (2018), “the United States consumes 80% of the world opioid supply” (793). Researchers note that, from 2000 to 2014, the opioid overdose death rate increased 200% in the country (Rudd, Aleshire, Zibbell, & Gladden, 2016). Speaking of New Jersey, in 2016, more residents were killed by drug overdose than guns, car accidents, and suicides (Stirling, 2019). One of the leading causes of the high rate of overdose death in the state is an inappropriate utilization of prescription painkillers to treat pain.
Opioid Therapy
The opioid mode of action is that it binds to opioid receptors in the central nervous system. According to the Centers for Disease Control and Prevention (CDC) (2019), opioids are drugs that “interact with opioid receptors on nerve cells in the body and brain” (para. 21). Opioids stimulate the release of endorphins, which are usually released naturally in the body when it is physically injured. The production of endorphins determines the absence of pain at the time of the accident.
Opioid medications are any drugs, both synthetic and natural ones, that work on nociceptors in the human body, and block pain signals. There are numerous opioid analgesics used as medication preparations: codeine, phosphate, tramadol, morphine, oxycodone, fentanyl, and others. There are a few conditions when a doctor might consider using opioid medication. They include the management of cancer, acute, and chronic or long-term mechanical types of pain. Acute pain and chronic pain are terms often used by patients to define the severity of their symptoms. Medically, healthcare practitioners use these two terms to define time. An acute episode lasts no longer than three months, like post-operative pain, whereas a chronic episode lasts longer than three months (Onishi, Masuzawa, Horita, Kawasaki, & Watanabe, 2018). Concerning the prescription of opioid medications, there is evidence for the use of these medications in an acute episode. For example, opioid drugs can be prescribed after trauma, a broken bone, or surgery.
Chronic pain is a frequent problem in adults and is often associated with disability to impaired quality of life. Some common types of chronic pain include mechanical neck pain, daily headaches, low back pain, and others. There is little evidence that a majority of people with chronic pain receive the right balance of benefits versus harm when they are given opioids on a daily basis (CDC, 2016). People can get addicted to the medications because of long-term use. Moreover, the prolonged use of opioids leads to neurological changes in the brain, meaning that everybody is at risk of developing physical dependence.
Benefits of Opioid Therapy
There are some advantages of opioid therapy, and the most significant one is that opioids are useful for the treatment of intense pain. The drugs are often prescribed in order to create a pain-relieving effect after surgery or severe injury. Another benefit of the therapy is that it can help to treat opioid addictions. For instance, methadone maintenance treatment (MMT) is often used as a method for addiction recovery. A synthetic opioid, methadone, is usually prescribed as a replacement for heroin. According to Juergens (2019), “methadone does not create the same euphoric effects as heroin or morphine because it is designed to do the opposite” (para. 5). The illicit use of heroin accounts for a large share of the health harms related to drug use around the world. During the MMT program, a patient who is dependent on heroin takes methadone instead of heroin to avoid severe withdrawal symptoms, such as panic, depression, muscle cramps, diarrhea, and anxiety. Patients are able to concentrate on getting the other aspects of their lives without having the adverse effects of recreational doses of opioids.
Risks of Opioid Therapy
Frequent use of opioids has a negative impact on human health and life as a whole. There are numerous side effects of opioid therapy, such as tolerance, withdrawal, depression, hyperalgesia, and addiction. A patient on opioid therapy often loses the ability to assess his responses to the medications because of the effects of them on the brain. Patients also usually overestimate the efficacy of these drugs and underestimate their adverse effects.
One of the most significant adverse effects of opioid therapy is opioid misuse that can lead to various problems with health and increase death risk. Researchers note that “from 1991 to 2011, the number of opioid prescriptions filled at US retail pharmacies nearly tripled, increasing from 76 million to 219 million per year” (Davenport & Matthews, 2018, p. 1). With the increase in prescriptions, the number of adverse outcomes increased as well. In the US, “overdoses involving opioids killed more than 47,000 people in 2017, and 36% of those deaths involved prescription opioids” (CDC, 2020). Concerning New Jersey, in 2018, there were 3,163 deaths due to drugs (Stirling, 2019). In part, it was a direct consequence of the high opioid prescribing rate: in 2018, healthcare providers wrote about 44 opioid prescriptions per one hundred persons (“New Jersey Opioid Summary”).
Another disadvantage of opioid therapy is connected with the risk of the use of illicit drugs after the course of opioid treatment. If a person who struggles with opioid addiction cannot get the drug from his healthcare provider, he usually starts replacing them with non-prescription medicines, like heroin. CDC data shows that approximately three out of four new heroin users report abusing prescription opioid medications before using heroin (CDC, 2019). In New Jersey, heroin-related deaths are more than three times the national average (“New Jersey’s Drug Addiction Crisis”). Individuals who lost access to legitimate sources turned to heroin in search of a cheaper, and more accessible replacement.
Conclusion
Since the 1990s, drugs of the opioid group have become widely used for the relief of acute and chronic types of pain. On the one hand, opioid therapy is an effective treatment program because it helps to reduce pain. It also decreases the likelihood of the use of illicit drugs. On the other hand, the use of opioids for treating pain often leads to numerous adverse effects for a person. The drug overdose deaths, including prescriptions of opioids, have been on the rise in New Jersey that has become a national challenge. Healthcare providers should be well aware of the long-term effectiveness of opioids and the associated risks, including addiction and death. If patients show symptoms of addiction, medical professionals should help them access resources, such as therapeutic and rehabilitative assistance.
References
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