Historical Overview of the Disease from a Public Health Perspective in the U.S.
Over the past 50 years, the opioid issue in the United States has developed and gone through several phases. The development of prescription opioids like OxyContin and Vicodin throughout the 1970s and 1980s was hailed as a breakthrough in pain relief (Dayer et al., 2019). These medications were advertised as being secure and non-addictive. But as opioids for treating chronic pain became more widely prescribed, more people became hooked.
Pharmaceutical corporations actively promoted prescription opioids to medical professionals in the 1990s, highlighting their efficiency in treating pain. This marketing effort minimized the dangers of addiction, which led to a dramatic rise in the number of prescriptions for opioids. Patients who trusted their doctors started using opioids more often as prescription drugs for various pain-related ailments.
As the number of prescriptions for opioids rose in the 2000s, so did the number of overdose deaths. Opioid abuse and diversion grew pervasive, and many people who had first developed a dependence on prescription opioids switched to using heroin since it was more readily available and less expensive on the black market. With the introduction of synthetic opioids, notably fentanyl, the opioid problem reached pandemic proportions in the 2010s.
Fentanyl is a particularly dangerous drug since it is far more powerful than conventional opioids. It started showing up in fake pharmaceuticals and illegal substances, which caused an increase in overdose fatalities. During this time, the opioid problem was increasingly recognized as a public health concern. The opioid issue persisted unabatedly into the 2020s, and the COVID-19 pandemic worsened matters. Lockdowns and disruptions in healthcare access and treatment services made it even more challenging for individuals with opioid use disorder to seek help.
Major Risk Factors for Opioid Abuse
To effectively prevent and intervene with opioid consumption, it is essential to understand the risk factors involved. The over-prescription of opioids by medical professionals, particularly for chronic non-cancer pain, has been a major factor in the epidemic. Patients prescribed excessive amounts of opioids run the danger of becoming dependent (Fernandez-Castillo et al., 2022). Conditions that raise the chance of opioid misuse can be brought on by socioeconomic variables, including poverty, unemployment, and a lack of access to high-quality healthcare because people may take opioids as a coping method.
People with mental health disorders, such as depression, anxiety, or post-traumatic stress disorder, are more vulnerable to opioid misuse as they may use opioids to self-medicate emotional distress. Genetics can play a role in an individual’s susceptibility to addiction. Some people may have a genetic predisposition that makes them more prone to developing opioid use disorder. Social networks that normalize or encourage opioid use can exert peer pressure on individuals, leading them to experiment with opioids.
Adverse Health Outcomes of Opioid Abuse
Abusing opioids can harm a person’s physical, emotional, and social well-being. Overdosing on opioids is a serious and perhaps lethal result of misuse. When opioids are used excessively, the respiratory system is suppressed to the point of respiratory failure. An essential aid in preventing fatal overdoses is the opioid overdose reversal drug naloxone. Constipation, respiratory troubles, an increased risk of infectious infections (such as HIV and hepatitis through sharing needles), hormone imbalances, and sexual dysfunction are just a few of the physical health concerns.
Opioid abuse often exacerbates or triggers mental health disorders such as depression, anxiety, and psychosis. These co-occurring conditions can complicate treatment and recovery. Opioid abuse can disrupt relationships, employment, and overall quality of life (Zhao et al., 2019). It often leads to social isolation, strained family dynamics, and financial instability. Opioid use disorder is characterized by a compulsion to seek and use opioids despite harmful consequences. It is a chronic condition that can be challenging to overcome without professional help, often requiring a combination of medication-assisted treatment and behavioral therapy.
References
Dayer, L. E., Painter, J. T., McCain, K., King, J., Cullen, J., & Foster, H. R. (2019). A recent history of opioid use in the US: Three decades of change. Substance use & misuse, 54(2), 331-339. Web.
Fernandez-Castillo, N., Cabana-Dominguez, J., Corominas, R., & Cormand, B. (2022). Molecular genetics of cocaine use disorders in humans. Molecular psychiatry, 27(1), 624-639. Web.
Zhao, S., Chen, F., Feng, A., Han, W., & Zhang, Y. (2019). Risk factors and prevention strategies for postoperative opioid abuse. Pain Research and Management. Web.
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