Final Argumentative Report

 

 

 

 

 

 

 

 

 

 

 

NIGHTMARE IN THE US

OPIOID CRISIS.

 

 

 

 

 

 

 

Anderson Lopez

ENG 201-94

Prof. Nargiza Matyakubova

November 13, 2020

OPIOID CRISIS

 

                       Opioids are deadly substances in the world, but here in the US they are creating a very high number of people that tend to abuse them. And, when they are abused, there is another big issue. The number of deaths is rising across America. But, in order to create an argument about opioid crisis in the US, we need to understand the epidemic, what are we talking about when referring to the opioid crisis, how many people die per year (statistics) by prescription or illegals opium. Who should be blame for it, physician, law makers, and/or patients? According to the CDC, the number of drug overdose deaths decreased by 4% from 2017 to 2018, but the number of drug overdose deaths was still four times higher in 2018 than in 1999. Nearly 70% of the 67,367 deaths in 2018 involved an opioid. From 2017 to 2018, there were significant changes in opioid-involved death rates.

                         From 1999–2018, almost 450,000 people died from an overdose involving any opioid, including prescription and illicit opioids (CDC, 2020). This rise in opioid overdose deaths can be outlined in three distinct waves. The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999 (CDC, 2011). The second wave began in 2010, with rapid increases in overdose deaths involving heroin (CDC, 2014). The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl. (CDC, 2016 & 2017). The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.

                       CDC is committed to fighting the opioid overdose epidemic and supporting states and communities as they continue work to identify outbreaks, collect data, respond to overdoses, and provide care to those in their communities. Overdose Data to Action (OD2A) is a 3-year cooperative agreement through which CDC funds health departments in 47 states, Washington DC, two territories, and 16 cities and counties for surveillance and prevention efforts. These efforts include timelier tracking of nonfatal and fatal drug overdoses, improving toxicology to better track polysubstance-involved deaths, enhancing linkage to care for people with opioid use disorder and risk for opioid overdose, improving prescription drug monitoring programs, implementing health systems interventions, partnering with public safety, and implementing other innovative surveillance and prevention activities. CDC’s work focuses on: Monitoring trends to better understand and respond to the epidemic. Advancing research by collecting and analyzing data on opioid-related overdoses and improving data quality to better identify areas that need assistance and to evaluate prevention efforts. Building state, local and tribal capacity by equipping states with resources, improving data collection, and supporting use of evidence-based strategies. Overdose Data to Action (OD2A) is a cooperative agreement that aims to increase the timeliness and comprehensives of data and to use those data to inform public health response and prevention activities. Supporting providers, healthcare systems, and payers with data, tools, and guidance for evidence-based decision-making to improve opioid prescribing and patient safety.

Partnering with public safety officials and community organizations, including law enforcement, to address the growing illicit opioid problem. Increasing public awareness about prescription opioid misuse and overdose and to make safe choices about opioids. Collaboration is essential for success in preventing opioid overdose deaths. Medical personnel, emergency departments, first responders, public safety officials, mental health and substance use treatment providers, community-based organizations, public health, and members of the community all bring awareness, resources, and expertise to address this complex and fast-moving epidemic. Together, we can better coordinate efforts to prevent opioid overdoses and deaths.

 

                       Ronald Hirsch, MD, is vice president, regulations and education group, R1 Physician Advisory Services, He wrote on his article, first, I will start with physicians. We overprescribe opioids, just as we overprescribe antibiotics. But it is generally well meaning; we don’t want our patients to experience pain. But then we prescribe 30 or 60 pills when 5 or 20 would have been adequate. We do that because we are used to prescribing in multiples of 30; 30 days for a month supply of a once a day medication, 90 days for a mail-order prescription. Prescribing 6 or 10 pills will undoubtedly result in a phone call from a pharmacist asking for a round number of pills, taking up time better spent entering meaningless information into our electronic health record systems. It is the leftover pills that sit forgotten in the medicine cabinet which often lead to trouble, stolen by a relative or visitor and abused. But sometimes it is that prescription that was provided for true pain that leads rapidly to tolerance and addiction. The role of these physicians can best be described as innocent bystander. We were truly trying to help the patient. But there are also what are known as “pill mill” doctors who set up shop, accept cash as the only payment and are willing to prescribe to anyone for any ailment, real or feigned. One physician in my area was so bold as to meet his “patients” in a local coffee shop to exchange prescriptions for cash. Needless to say, he is no longer licensed to practice medicine. Doctors such as these are criminals and need to be stopped. They cast a long shadow on the work of every other physician trying to help patients (Missouri Medicine, 2017).

                       The US government on its help to fight the opioid crisis are focusing on Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term recovery, also on targeting the availability and distribution of overdose-reversing drugs to ensure the broad provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations. Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response as the epidemic evolves. Also, supporting cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms; and advance the practice of pain management to enable access to high-quality, evidence based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.

                       Clearly, argumentatively speaking the opioid crisis is real in the US. This is not just the physician’s fault. It is the fault of everybody involved, it is the fault of the patients that don’t look for help, when they need it. And when they do, it is to late. The government has a lot to do with the problem, mainly because its inability to regulate or control the production and distribution of these narcotics. And, finally in my opinion it was the doctor’s fault also, I am leaning into this position due to their negligence, like mention on this paper by the way how they just care of profiting, and not on the wellbeing of patients. Finally, the opioid crisis is real, it is not a game as many skeptical people think, please think smart, don’t do abuse opioids.

 

 

Reference:

1. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2020. Available at http://wonder.cdc.gov.
2. Wilson N, Kariisa M, Seth P, et al. Drug and Opioid-Involved Overdose Deaths—United States, 2017-2018. MMWR Morb Mortal Wkly Rep 2020;69:290-297.
3. Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers—United States, 1999–2008. MMWR MorbMortal Wkly Rep. 2011 Nov 4; 60(43):1487-1492.
4. Rudd RA, Paulozzi LJ, Bauer MJ, Burleson RW, Carlson RE, Dao D, Davis JW, Dudek J, Eichler BA, Fernandes JC, Fondario A. Increases in heroin overdose deaths—28 states, 2010 to 2012. MMWR MorbMortal Wkly Rep. 2014 Oct 3; 63(39):849.
5. Gladden RM, Martinez P, Seth P. Fentanyl law enforcement submissions and increases in synthetic opioid-involved overdose deaths—27 states, 2013–2014. MMWR MorbMortal Wkly Rep. 2016; 65:837–43.
6. O’Donnell JK, Gladden RM, Seth P. Trends in deaths involving heroin and synthetic opioids excluding methadone, and law enforcement drug product reports, by census region—United States, 2006–2015.MMWR MorbMortal Wkly Rep. 2017; 66:897–903.
7. O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM. Deaths involving fentanyl, fentanyl analogs, and U-47700—10 states, July–December 2016. MMWR Morb Mortal Wkly Rep. 2017; 66:1197–202.

8.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/. The Opioid Epidemic: It’s Time to Place Blame Where It Belongs, Missouri Medicine, 2017