The National Opioid Crisis and Fentanyl Abuse in Ohio

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More than 130 people die every day from an opioid-related drug overdose. In 2017, Ohio had the second-highest rate of drug overdose deaths involving opioids – 39.2 deaths per 100,000 persons, compared with the national average of 14.6 per 100,000 persons.

According to the National Institute on Drug Abuse, “In 2016, synthetic opioids (primarily illegal fentanyl) passed prescription opioids as the most common drugs involved in overdose deaths in the United States.” The opioid crisis, including fentanyl abuse, is a serious issue being addressed by both the federal government and the state of Ohio.

To learn more, check out the infographic below created by Ohio University’s Online Master of Health Administration

How health agencies are combating the epidemic of opioid and fentanyl misuse.

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The National Opioid Crisis and Fentanyl Abuse

What starts as taking prescription pain medication can lead to opioid misuse, addiction, and even overdose or death. The national opioid crisis has claimed thousands of lives and still holds millions of others dependent on the pain-relieving powers of opioids.

 A Background on Opioids and Opioid Misuse

The National Institute on Drug Abuse defines opioids as “a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.” Opioid misuse includes using without a prescription; using in greater amounts, more frequently, or for longer than directed by a physician; and using in a way that is contrary to a physician’s instructions. An opioid overdose can be reversed by administering naloxone.

Statistics of Opioid and Fentanyl Fatalities

In 2016, 11.8 million individuals misused prescription opioids, 2.1 million individuals have had an opioid use disorder, and there were 42,249 overdose deaths attributed to synthetic opioids, prescription opioids, and heroin overdoses.

Fentanyl misuse is particularly noteworthy because it’s an opioid that’s used under medical supervision as a pain reliever considered to be 80 times more potent than morphine. Illicitly manufactured versions are largely responsible for the 300% increase in overdose deaths related to synthetic opioids since 2013.

Measuring and Identifying Risk

Lower-income individuals are at higher risk of opioid use disorder, as are those on Medicaid or those without health insurance. Studies also indicate opioid usage and death rates correlate to socioeconomic factors such as increased unemployment rates, lower rates of labor force participation, and rural settings.

History, Causes, and Factors

The opioid crisis has been divided into three phases: The beginnings of treating chronic pain in the 1980s, the increase in heroin deaths in 2010, and the current state of the crisis since 2013.

The Journey from Chronic Pain to the National Opioid Crisis

In the 1980s, propoxyphene was frequently prescribed to treat acute pain, to the point where it became the second-most common drug in the U.S. In the 1990s, research revealed undertreated chronic pain that was previously managed with cognitive behavioral therapy and hypnosis.

During the 2000s, rates of chronic pain increased due to issues like obesity, increased injury and cancer survival rates, and higher patient expectations for pain relief. This coincided with some pharmaceutical marketing campaigns which, according to the American Journal of Public Health, “improperly minimized addiction potential (OxyContin®) and promoted off-label use (Actiq),” which eventually led to things like an increase in physician kickback schemes, lobbying, and careless prescription tactics.

Additionally, heroin overdose deaths tripled between 2010 and 2015, potentially due to a greater pool of vulnerable individuals. In 2016, deaths attributed to illicitly manufactured fentanyl and related drugs increased by 540% since 2013 across the U.S., thanks in part to more potent products hitting the market.

 Why the Opioid Crisis Continues

The results of the 2015 National Survey on Drug Use and Health (NSDUH) showed most misuse of prescription pain relievers was to relieve physical pain. Other key reasons for misuse was to achieve a high or to relax. Today, factors influencing the ongoing crisis include limited drug treatment and eroding economic opportunity.

Strategy, Solutions, and Resources

A nationally declared emergency spurred initiatives and programs across government departments and local communities addressing the opioid crisis. Americans today have access to resources at the local, state, and national levels offering tips to help prevent opioid misuse and information about safely managing chronic pain.

The Five-Point Opioid Strategy

The U.S. Department of Health and Human Services has developed a five-point plan to deal with the opioid crisis. The points include improving access to treatment, promotion of overdose-reversing drugs, strengthening understanding of the epidemic via public health surveillance, supporting cutting-edge pain and addiction research, and developing better pain management practices.

Opioid Epidemic Priorities Outlined by SAMHSA

SAMHSA has created a list of components that should be in a community’s prevention, treatment, and recovery efforts. These components include criminal justice programs, recovery housing, funding services to reduce opioid abuse, and increasing the number of qualified providers.

There are also several national and local resources that can be accessed to help in this fight. These resources include the Ohio Department of Health, Centers for Disease Control and Prevention, and the United States Department of Health and Human Services.

Working Together on a Serious Issue

The opioid epidemic highlights the interdisciplinary issues surrounding health care, which is why government officials, health care providers, and the medical community are working in a collaborative effort to address the issue. As researchers and health care professionals develop methods of safely managing chronic pain, and as local communities increase support for vulnerable individuals, the opioid crisis will continue to decrease.