Pain or Opioid Dependence?
Statistics
● From 1992 to 2003 misuse of opioid prescription painkillers increased by 140%
● Americans, who represent less than 5% of the world’s population, are by far the largest group of opioid users; 80% of the world’s supply of opioids (and 99% of the hydrocodone available globally) are used by people in the United States
● The increase in the legitimate use of opioids has been paralleled by a rise in abuse of these drugs, with a 63% increase in opioid deaths during the 5-year period from 1999 to 2004
● Multiple investigations have shown prevalence of drug abuse around 20% and as high as 58% in patients receiving opioids for chronic pain
● According to the 2005 National Survey on Drug Use and Health
almost 2 million Americans are opioid dependent and approximately 4.7 million teenagers and adults have used opioid prescription painkillers for nonmedical purposes
● Approximately 32.7 million Americans report having used opioid prescription painkillers for nonmedical purposes at least once in their lives
Disease
● Opioid dependence is recognized by the World Health Organization as a brain disease
● Opioid dependence is a condition that involves physical, psychological, and behavioral need for opioid, and affects every aspect of a person’s life
● The misuse of opioids can create euphoria of such intensity that it reinforces drug-taking behavior and resets the brain to believing that opioids are necessary to survive
● Opioid prescription painkillers are chemically similar to heroin and can be as addictive as heroin
● Adults abusing opioids typically acquire them by one of the following methods: doctor shopping, stealing them from parents or relatives, buying them from classmates who are selling legitimate prescriptions, or buying them from illegal Internet pharmacies or other vendors
● When an opioid-dependent person stops taking opioids, severe physical withdrawal symptoms occur, and he/she often develops intense cravings for the drug. These cravings can be so powerful that people find it extremely difficult to stop taking opioids
● The social stigma attached to opioid dependence is so strong that some people prefer continue using opioids to the risk of possible exposure by seeking treatment
Treatment
● Historically the primary treatment option for patients with opioid dependence has been methadone, most often administered in a clinic setting
● Psychosocial counseling is a critical component of opioid-dependence treatment
● A new treatment option has been available since 2003, which can be prescribed by trained physicians in the privacy of an office setting
● Opioid dependence can now be managed medically—in the same way that other chronic illnesses like diabetes and hypertension are managed
● Many individuals are inclined to be treated in the privacy and convenience of a physician’s office
● According to several conservative estimates, every dollar invested in opioid-dependence treatment may yield a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft alone. When savings related to health care costs are included, the ratio can equal 12:1 for every dollar invested
