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The Battle Against Opioid Abuse: Signs Of Progress But Still An Epidemic
On July 12 the Blue Cross Blue Shield Association published "The Opioid Epidemic in America: An Update," revealing a 0.3 percent drop in the 2017 rate of claims filed for opioid use disorder. Interviewed by Vox, Brandeis University's Andrew Kolodny said, "The decrease in new cases of opioid addiction is likely due to the trend in more cautious prescribing and greater public awareness of opioid risks."
While this limited good news is precious, deaths by overdose or Fentanyl contamination remain at record highs — America's opioid epidemic is still taking its toll in lost lives and the trauma that impacts survivors hurt by this tragedy-in-progress.
The BCBSA data support findings announced in April by the IQVIA Institute for Human Data Science, which found a 10 percent reduction in 2017 new prescriptions for opioids as well as close to a 100 percent increase in prescriptions for medications to reduce opioid addiction, such as buprenorphine. But tragedies still pile up on the fringes of this progress, as children taking buprenorphine intentionally or by accident have resulted in thousands of calls to emergency rooms. Staying safe is an ongoing challenge.
On April 4 the National Institutes of Health announced their launch of the HEAL (Helping to End Addiction Long-term) Initiative, with a budget of $1.1 billion for 2018 granted by Congress.
"Every day, more than 115 Americans die after overdosing on opioids," said NIH director, Dr. Francis S. Collins. "That is a four-fold increase since 2000, and the numbers continue to climb. … NIH has worked with stakeholders and experts across scientific disciplines and sectors to identify areas of opportunity for research to combat the opioid crisis. The focus of these discussions has centered on ways to reduce the over prescription of opioids, accelerate development of effective non-opioid therapies for pain, and provide more flexible options for treating opioid addiction. NIH is committed to bringing the full power of the biomedical research enterprise to bear on this crisis."
Once again, this is welcome good news, but these efforts are being made to diminish damage caused by an ongoing epidemic.
A June interview by the University of Michigan's wellness newsletter with its Assistant Professor of Psychiatry Dr. Jonathan D. Morrow surveyed the 11 important signs considered indicators for opioid use disorder. Many of these are familiar to those used to dealing with addiction — such as "continued opioid use despite related social or interpersonal problems" — but being alert to these signs of trouble is a critical part of increased awareness, and that is one aspect of the epidemic we can improve personally.
Once the line of overuse has been crossed, often by people in desperate circumstances, obligations begin to go by the wayside, continued use despite problems sets in, followed by withdrawing from social activities. The victims of overuse continue to dose themselves even in risky physical situations and despite related physical or psychological issues that can grow worse and need independent attention.
In these later stages, withdrawal symptoms can become acute and continue the drive to use more, while becoming accustomed to the substance's intake means larger amounts — ever larger amounts — are required to achieve the effect once accomplished by smaller doses.
"The drugs make the brain seek out more," said Morrow, "regardless of what the outcome of that drug use was."
While addiction and its treatment is always serious, with tragic risks only some of which can be avoided, opioid abuse is particularly deadly. More awareness can be the difference that helps people trapped in the dangerous cycle of abuse.