by Lisa Gruenloh
During 2016, more Americans died from opioid overdose than the 43,000 Americans who died over the 20-year span of the Vietnam War. That sobering statistic was one of many shared by national opioid expert Dr. Andrew Kolodny, who led a two-day summit of physicians and other health practitioners committed to addressing the opioid epidemic.
“It’s not just gradually getting worse,” Kolodny said. “It’s getting worse very quickly.”
Additional impacts of the opioid crisis – increases in infants born opioid-addicted, children forced into foster care due to their parents’ addictions, and impacts on the workforce. The driver of all of these impacts is the increase of Americans suffering from opioid addiction, Kolodny noted.
“The opioid epidemic is not a drug abuse crisis. It’s not about people behaving badly because it feels good,” Kolodny said. “It’s an epidemic of addiction. They are not doing it for fun anymore. The vast majority of people who die from opioid use are addicted.”
Kolodny noted that many people in their 40s through 80s can be addicted and not realize it, and their doctors don’t always acknowledge it either. Older adults generally do not have a hard time finding a doctor who will prescribe opioids for treating chronic pain, and the addiction issue is often overlooked.
“The doctor doesn’t want to put a label on their patients as addicts, so the patients don’t get referred to addiction treatment. They get referred to pain management specialists,” Kolodny said.
A common treatment, of course, is an opioid prescription, despite the fact that opioids often make pain worse, he added. “When you take people off opioids, their pain often improves.”
Opioid addiction is increasing among younger people as well. Kolodny shared three primary ways those in their 20s and 30s become addicted: they are prescribed opioids for a serious medical issue and injury and get addicted; they have access to prescription opioids in their home and use it recreationally; and in other cases, the person had early exposure for a medical reason and later began abusing it.
Often those users believe it is safe since they took it before and it didn’t hurt them.
A recent phenomenon related to increased opioid addiction in younger people is a parallel increase in black market activity and heroin addiction. Koldony explained that while Oxycodone costs about $30for a 30 mg pill, an entire bag of heroin costs about the same, and produces similar effects. This trend is bringing heroin to parts of the country that never had it before. It’s a cheaper way of feeding the devastating addictions that frequently begin with opioid use.
“People addicted to heroin no longer take it because they enjoy it,” Kolodny said. “They take it because they have to in order to avoid feeling awful.”
And it’s not because of the intense flu-like symptoms that occur through withdrawal, which are painful, Kolodny stated. ”What drives the desperatebehavior are the psychological impacts. People addicted to opioid experienceintense anxiety – a sense of impending doom. You feel like you’re going to die.
”Today’s heroin is not the same as that available during the heroin epidemic of the 70s. Heroin deaths are rising due to heroin that has been laced with fentanyl, a 100 percent synthetic, extremely potent substance. “We’ve never had a more dangerous heroin supply,” Kolodny said. “A bag of heroin with just a touch of fentanyl can be fatal.”
The increased availability of both prescription and illicit opioids is not helping the epidemic. While Florida has made progress cracking down on pill mills, Kolodny said, but there hasn’t been a crackdown on prescribing.
“We need more cautious prescribing, and ensure we’re not stocking everyone’s home with a highly addictive drug.”
Addressing the opioid epidemic is similar to addressing any major public health issue, Kolodny said. He suggested a three-part focus: prevent new cases of opioid addiction, treat those already addicted to opioids and reduce the supply of opioids from pill mills and the black market, which is where law enforcement comes in.
Dr. Kolodny’s visit further solidified the medical, health and public safety community’s resolve to reduce opioid abuse and addiction, according to Drug Free Collier CEO Guy Blanchette. Community leaders in the health care, prevention, treatment, judicial and law enforcement sectors will be meeting the coming weeks to a community-wide action plan to build on existing efforts to reduce opioid prescriptions, address opioid addiction and enhance diversion initiatives.
Lisa Gruenloh is director of program development for Drug Free Collier, responsible for the organization’s youth development, life and leadership skills programming.