Drug problems and addiction are certainly nothing new in this country, but recently, the opioid problem in America was officially labeled as an epidemic. Why? Because in 2014, more than 28,000 people died from opioid overdose. At least half those deaths involved a prescription opioid. So although millions of prescription opioids have been obtained legally over the years, most of the deaths are the result of drugs being misused or abused, often after being illegally obtained from a loved one or friend.
What are opioids?
The most commonly prescribed opioids are used to treat moderate to severe pain. They're often prescribed following surgery, injury or for chronic pain. They're also often prescribed for issues such as back pain or osteoarthritis, despite serious risks and lack of evidence about their long-term effectiveness.
Why has there been such a sharp increase in overdose cases?
Even though pain levels in the U.S. have not increased since 1999, nearly four times as many opioid prescriptions were written in 2014 than in the 15 years prior. Certainly no one enjoys being in pain, and if a prescription is needed, one should be offered. However, more pills are being prescribed than are needed. It’s estimated that one out of five patients with noncancer pain or pain-related diagnoses are prescribed opioids; and even though prescription rates are highest among pain medicine, surgery and physical medicine/rehabilitation specialists, about half of opioid pain relievers are dispensed by primary care providers.
If someone is suffering from a chronic pain condition like rheumatoid arthritis or fibromyalgia, or if they’re undergoing chemotherapy, that person may need opioids to simply get through the day. However, the problem is that many more people than this are being prescribed these same medications. Often, the entire prescription is not taken or monitored, and these unused pills are sometimes falling into the hands of teens and young adults who misuse them.
One recent study found that more than half of opioids prescribed to patients following wisdom teeth removal went unused. The researchers followed 79 patients for several weeks after their surgeries to assess their pain levels and corresponding opioid use. They found that 94 percent of patients filled a prescription for an opioid medication, and those who did not have any post-surgery complications received an average of 28 opioid pills. However, after three weeks, only an average of 13 of those 28 pills received had been taken. All told, that left more than 1,000 unused pills.
What’s happening to the leftover pills?
Interestingly, the problem of opioid addiction remains unlikely to take hold of the person for whom the opioids were initially prescribed. A new study out of Toronto Western Hospital measured rates of ongoing opioid use for patients up to a year after undergoing major surgery. Their research included 39,140 patients who were given no opioid prescriptions in the previous year but who were given one or more opioid prescriptions within 90 days of being discharged from the hospital.
The authors purposely picked people who underwent major elective surgeries, and therefore people less likely to be suffering from chronic pain. Basically, these were people who shouldn't need opioids a year later to get through the day, and this overwhelmingly appeared to be the case. By one year after the surgery, only 168 out of 37,650 surviving patients (or 0.4 percent) were receiving ongoing opioid prescriptions.
So getting a prescription for opioids and then taking that medication as prescribed doesn’t appear likely to cause an addiction. In fact, the problem arrives because people only take these drugs for as long as they feel they need them. I’ve certainly done the same thing, simply because these medications tend to keep me in a perpetual bad mood. But it’s becoming increasingly clear that after we’re done with these medicines, they need to be disposed of properly. Because they’re often forgotten and unused, they fall into the hands of teenagers and young adults, and it’s this age group where abuse has become rampant.
What should you do?
If you don’t need a prescription for an opioid, either because your pain levels don’t require it or you can’t tolerate the side effects, tell your doctor. If you end up with a prescription but don’t plan on using it, shred the paper and throw it away. If you do fill a prescription but don’t take all the medication, dispose of it properly—don’t just leave it sitting in your medicine cabinet for anyone to find. While most medicines can be thrown away safely by following these instructions, others cannot.
You can visit the Drug Enforcement Administration website for information about proper drug disposal and any drug take-back programs in the area. However, the Federal Drug Administration recommends that opioids such as fentanyl, hydrocodone and oxycodone be disposed of by flushing them down the sink or toilet as soon as they are no longer needed. They believe that any potential risk to human health or the environment caused by flushing is far outweighed by the risk of leaving the drugs unattended in your home.
Fortunately, plans are underway to drastically reduce the number of opioid prescriptions written in the U.S. every year. This will undoubtedly save lives and, by cutting off the supply, prevent many cases of opioid addiction from ever happening. In addition, because over 2 million Americans meet the criteria for opioid dependence, the economic burden of this problem has ballooned to nearly $80 billion a year. Awareness of this problem has enabled our country to begin to fight back, but for each individual case, sufferers need all the help and support family and friends can offer. Visit this site for more information on how you can do more.
Jay McKenzie loves soccer, history and feeling great. He's on a quest to eat better and exercise more, and he wants to share his experiences along the way. You can email him at firstname.lastname@example.org with comments or questions. The opinions expressed in this column belong solely to the author, not Nooga.com or its employees.