Written by Vishwesh Dayal
According to the National Institutes of Health (NIH), nearly 108,000 people died from drug overdose in 2022 alone. This is a sharp increase from 92,000 deaths in 2020 and 52,000 deaths in 2015. Furthermore, synthetic opioids accounted for 74,000 deaths in 2022, nearly 69% of all overdose deaths, a drastic change from the 10% of overdose deaths caused by synthetic opioids in 2014. This drastic doubling of overdose deaths in just 5 years specifically caused by an emerging opioid epidemic reflects a major problem for the American population. Not only does it place additional pressure on individuals being overprescribed addictive medications, but the opioid epidemic has drastic widespread effects on the rest of society. Research has shown that substance abuse can very quickly lead to long-term health consequences through the spread of infectious diseases and health conditions stemming from addictive medications. According to the Center for Disease Control (CDC), sharing needles and similar drug injection apparatuses can spread Human Immunodeficiency Virus (HIV), further increasing the long-term health risks of individuals with drug addiction. The CDC also states that 1 in 10 HIV diagnoses in the United States are due to drug injection.
In the 1990s, opioid manufacturers began aggressively marketing medications like OxyContin, encouraging physicians to prioritize medication-based pain management. This push had ranging effects, as opioid sales quadrupled between 1999 and 2010 and overdose-related deaths went from 2.6 per 100,000 to 6.8 per 100,000 in the same period, known as the first wave of the opioid epidemic. The rise of the second wave came from increased heroin use, causing heroin related deaths to increase 5x just between 2010 and 2016. The largest jump in mortality came in the past decade with synthetic opioids such as fentanyl to start the third wave of the opioid epidemic. Pharmaceutical fentanyl is used for severe pain management but can be very addicting in extremely small amounts, with the Drug Enforcement Agency (DEA) estimating that just 2 mg can be a lethal dose. Fentanyl has dangerous health effects including coma and respiratory failure, with addiction starting as soon as after the first dose.
Having over 300 hours of experience handling addictive, controlled medications and explaining to patients their proper use as a pharmacy technician, I believe there are effective long-term solutions to slow the opioid epidemic. First and foremost, public education and awareness are crucial to train people to recognize the dangers of addictive medications and reduce their stigma. These campaigns can start as early as middle school to educate teenagers about common addictive medications and their impact through workshops and discussions.
Specifically, education administrators should focus their efforts on teaching strategies to battle peer pressure and stress. Dealing with the pressure of school and life coupled with influence from peers is a primary reason teenagers start using illegal substances. Curbing this trend at its birth will create a new generation armed with the proper resources and education to avoid addictive substances, preventing unnecessary death and improving community health.
I believe there are effective long-term solutions to slow the opioid epidemic.”
Another important venue to combat drug abuse is through family and patient education. Government-sponsored education programs backed by research should be taught to parents nationwide with a focus on recognizing symptoms of addiction in adolescents and to create a supportive community without stigma. It is also important to mandate all healthcare facilities to inform patients about each addictive medication being prescribed to them, and give them the option to opt-out for a safer alternative, if available. This encourages patients to be proactive about their health and will drastically lower cases of prescription-caused addiction. My role as a pharmacy technician elaborates on this as I help educate patients about their prescription and its side effects, especially for controlled, addictive medications. Taking this role to a nationwide level would significantly improve public health and lead to a healthier population.
By restructuring provider education and investing in alternative treatments for pain medication, addiction can be reduced and patient outcomes can be drastically improved. One such step would be to encourage all medical & pharmacy schools to dedicate courses for pain management and understanding substance abuse. A survey by the Association of American Medical Colleges (AAMC) found that in 2018, 87% of medical schools in America had some incorporation of pain management in their curriculum for medical students. This is a big step in the right direction, and the number of hours spent on learning safe pain management techniques should increase, creating a new generation of providers better equipped to prevent addiction.
Strictly monitoring dosage guidelines and ensuring proper dispensing is crucial as it limits the amount of addictive substance used and prevents it from reaching the wrong hands. In my pharmacy, controlled substances categorized by the DEA are stored in a secure vault, with the quantity and use carefully tracked to ensure the right amount is given to the right person.
It is vital to simultaneously invest in other non-addictive pain medications such as anticonvulsants, nonsteroidal anti-inflammatory drugs (NSAIDs), and acupuncture/yoga to limit exposure of opioids to the public. Dr. Nicolas Bazan from Louisiana State University (LSU) Health unveiled a new drug which may be a promising alternative. SRP-001, a non-opioid painkiller, provides the same instant pain relief, but lacks the dangerous addictive side effects.
This drug passed Phase I of human clinical trials and has received Food & Drug Administration (FDA) Fast Track approval for pain management, providing hope to millions struggling with intense pain. Another exciting alternative comes from VS-548, which acts as an oral inhibitor of a voltage-gated sodium channel involved in pain sensation. Similar to SRP-001, this is also not addictive and has promising results in current clinical trials. With continuous investment and research into other routes, opioid prescription and use can drastically decrease and lead to better patient outcomes.
Another specific initiative that should be urged nationwide is the use of Naloxone, which works as an opioid antagonist. This means that Naloxone, known by its brand name Narcan® binds to opioid receptors in the brain and reverses an opioid overdose, saving lives quickly and efficiently. A study in San Francisco found that Naloxone successfully reversed 89% of overdoses, restoring normal breathing and saving lives. According to the CDC, Naloxone can counter fentanyl, morphine, heroin, oxycodone, and codeine, some of the most dangerous and addictive drugs in the world. Naloxone can also be administered through an injection under the skin, directly in the muscle, or be sprayed directly into the nose. A vital advantage is its harmlessness to someone who is not overdosing, meaning a bystander would not have to evaluate if a person is overdosing and can administer it regardless. In September 2023, naloxone was approved as an over-the-counter (OTC) medication, meaning no prescription is required to purchase it and increasing its access to the community. The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) reported that between October 2017 and June 2024, at least 103,000 lives were saved because of Naloxone.
A common factor I often observe in patients while discussing their prescriptions is their hesitancy to disclose their substance abuse disorder (SUD). Knowing a patient’s history of drug use is crucial in creating a treatment plan, and patients’ fear of stigma surrounding their drug use can lead to withholding of vital information. This can lead to treatment plans that do not address the primary issue and could be dangerous for the patient’s health. Due to the worldwide stigma regarding drug use, many addicts are unwilling or hesitant to seek treatment for their condition, further worsening their health. Drug use can also create a spiraling cycle in which people isolate themselves in shame due to their condition, and that isolation further fuels their desire to use harmful substances. Furthermore, one of the biggest reasons for withholding information I hear from patients is their fear of discrimination from healthcare staff and potential criminalization. Patients with SUD feel as if they will be treated differently and receive worse quality of care if they disclose their condition, putting their health at risk. Patients also report their fear of criminalization as one of the primary reasons for not disclosing their condition. As a healthcare worker, our main priority should be to improve the health and well-being of a patient, rather than reporting the legality of a patient’s drug use to the authorities. Reducing the stigma around addiction and improving patient-provider trust are critical steps that must be continuously invested in to save lives and improve long-term community health.
Widespread addiction from the opioid epidemic creates extra strain on the healthcare system. Due to the frequency of overdoses when using addictive substances, visits to the emergency department (ED) are more common to treat those symptoms. The CDC reported that between July 2016 and September 2017, opioid overdose visits to the ED increased by 29.7% nationwide, placing tremendous strain on healthcare workers. This trend also leads to increased healthcare costs, as hospitals and clinics now have to accommodate extra patients, resources, and staff to treat overdoses, increasing the cost of insurance and treatment. Burnout and exhaustion from handling the increased influx of overdoses leads to workforce shortages which can further reduce the quality of care for patients. This epidemic also requires extra effort from social workers and mental health services as they are stretched thin trying to handle the sudden increase in cases. A national survey on drug use found that 62% of people with an opioid use disorder (OUD) also had a mental illness, but less than half received treatment for the latter. Beyond this, the impact on families and communities throughout the country is drastic. Evidence from the Federal Communications Commission (FCC) finds that 187 people die from opioid use each day, affecting rural communities with limited resources and funding the most. This crisis has destroyed families through addiction and dependence, ripped apart communities, and is one of the largest causes of preventable death in America.
The sudden change in opioid use and addiction in the past few decades has brought many unexpected challenges with drastic effects. Despite this, people and communities have rallied together and fought back, creating initiatives, encouraging education, and investing in alternatives to protect the future of pain management. This requires a group effort from all of us, each person can make a positive impact in their community and empower themselves to make responsible choices and look after their loved ones. Reducing the stigma around substance abuse along with investment in mental health resources will go a long way in curbing the opioid epidemic. Increasing collaboration between healthcare workers, mental health specialists, social workers, and policymakers to implement treatment plans will make great progress against this issue, but only if we all work together. I am glad to contribute my experience as a pharmacy technician to this cause by empowering and educating my patients to improve their well-being. I encourage everyone reading this to ask themselves how they can help their community and raise awareness to create a future free from addiction and loss.
