Summary: Despite declining opioid prescriptions, opioid overdose-related events are increasing. Buprenorphine is among the first and most effective drugs to treat opioid use disorder (OUD). Unfortunately, a new study shows that those with a treatment gap are almost three times more likely to overdose on opioids. Thus, buprenorphine noncompliance must be regarded as a significant red flag.

Opioid use may be declining, but not opioid abuse. As pressure on doctors mounts, they are increasingly hesitant to prescribe opioids. However, data shows that this did not result in a decline in opioid abuse and opioid overdose-related deaths. In fact, opioid overdose deaths in 2021 were almost 50% more than in 2020, causing more than 70,000 fatal outcomes.

It means that there is still a need to understand or identify the causes of opioid overdose. It is essential to provide proper treatment to those living with opioid addiction. There must be more effort to prevent opioid overdose-related deaths. One of the ways to prevent these deaths is to identify the red flags and individuals at the greatest risk of overdose. Now the study shows that those who do not use buprenorphine medication regularly are considerably more likely to die of opioid overdose.

Buprenorphine is also a kind of opioid, but a safer opioid used to treat opioid use disorder (OUD). It is often prescribed as a part of opioid addiction treatment and is quite good. It is among the first medications approved for treating OUD. However, treatment outcomes depend on how regularly one uses any medicines. Thus, compliance is the key, and OUD treatment with buprenorphine is no exception.

In the new study published in one of the most reputed journals JAMA Psychiatry, researchers analyzed the data of 34,505 patients receiving buprenorphine medication under the Medicare scheme. They found that the treatment gap was more common in young males and those living with disabilities. However, more importantly, researchers found that the risk of opioid overdose in such individuals was 2.89 times higher than in nontreatment gap beneficiaries.

The difference of almost three times higher risk in different groups is massive and considerable. It is something vital to know. There were some other interesting findings in the study. The treatment gap increased the risk by 2.84 times in those prescribed 16mg/d of buprenorphine. However, this risk was 3.62 times in those taking 8mg/day or less. It means that the risk was higher in young patients or those in whom treatment had not been started long ago. 

These are interesting findings in many aspects. It is among the few studies that could identify a major red flag pointing to the risk of opioid overdose and related deaths. It shows that there is an urgent need to improve compliance in those taking opioid addiction treatment.

Of course, compliance is important in any treatment. However, no one imagined that noncompliance with buprenorphine treatment might be associated with such a massive opioid overdose risk. 

These findings are relevant both for the doctors and those living with OUD. For patients, it is vital to understand that they are risking their lives by not following the treatment. Therefore, one should avoid the casual approach, avoid seeking opioids, and instead try sticking to the treatment.

It is a wake-up call for doctors, healthcare workers, and policymakers to start taking opioid addiction treatment compliance more seriously. It is evident from the study that nontreatment compliance is one of the most significant overdose risk factors. Unfortunately, in many cases, identifying noncompliance is not an issue, especially in the age of electronic health records. Hence, steps must be taken to identify such patients and provide greater medical care to such individuals to prevent unfortunate events.

Summary: A new annual survey report by the University of Michigan shows that opioid misuse in young adults has fallen to a new record low level in 2021 since its peak in 2006. Now just about 1.7% of young adults misuse prescription opioids. However, the study found that marijuana and hallucinogen use has increased in young adults. Similarly, alcohol use remains quite common. Thus, the study shows a shift in the substance abuse landscape.

Misuse of prescription opioids has fallen to the record lowest level in young adults in the US. In the year 2021, the lowest number of young adults abused prescription opioids since 1975, a survey found. But, of course, this does not mean that substance use disorder has become less severe. It also does not mean that opioid overdose-related deaths have declined.

Here it is vital to understand that prescription opioids are a vague term. It generally includes opioids like hydrocodone and oxycodone. Further, it is worth understanding that this report is about prescription opioid misuse and not essentially opioid overdose and related deaths. Nevertheless, it means that though the abuse of prescription opioids continues to decline, opioid overdose-related deaths continue to increase.

So, no, opioid overdose-related deaths are not decreasing. Opioid misuse is also not showing any signs of decreasing. Nonetheless, there is good news prescription opioid misuse is decreasing. These findings are significant since it shows that opioid prescription by doctors is not fueling opioid addiction treatment, as proposed by many. These new findings regarding a significant decline in prescription opioid misuse by young adults were published by the Institute for Social Research, The University of Michigan. They published this information in their Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 60, 1976-2021.2

As per this new study, now only about 1.7% of young adults are abusing prescription opioids, which they generally describe as “narcotics other than heroin.” This is a massive decline from a peak of about 9% in 2006. Moreover, it means that most adults who are prescribed opioids are using them responsibly. The MFT survey and CDC data confirm that prescription opioid misuse has been declining. However, the opioid overdose epidemic continues mainly due to illicitly procured fentanyl and other opioids.

One of the reasons for such a decline in opioid misuse has been a significant decline in opioid prescriptions by doctors. Market data shows that prescriptions of opioids have also fallen to half since their peak in the early 2000s. However, the picture is not as rosy as it may sound. Though prescription opioid misuse is declining consistently, the use of illicit opioids is not declining. Even worse, the misuse of many other substances is increasing. Thus, now more young adults are abusing marijuana and hallucinogens, compared to the year 2000.

Not only that, but the MFT survey also found other causes of concern, like alcohol misuse is not showing any signs of significant decline. Similarly, vaping is gaining momentum. Though people may not be smoking cigarettes, they are now vaping nicotine more frequently. These findings show that the drug landscape is shifting fast. It shows that pattern of drug misuse is changing fast. It means that now doctors need to focus on the ill effects of marijuana and hallucinogens misuse. They also need to focus more on other drugs, like stimulants, that continue to cause significant mortality.

Further, alcohol use disorder still remains a significant problem. It appears that though heavy drinking has been declining in the last few years, things changed in 2021. It appears that the Covid-19 pandemic caused a significant increase in alcohol consumption.

Summary: Opioid overdose-related death is a significant problem in the US. Experts think identifying the population groups at a greater risk of opioid addiction may help counter this threat. Researchers at the University of Cincinnati analyzed the health data of Ohio state and found 12 population clusters where opioid addiction is more common. They found that white men aged 30-39 were more likely to abuse opioids, and black men aged 30-39 were at greater risk of death due to an overdose.

 

If we want to overcome opioid addiction, we need to identify the groups at risk and then work with them. For this, there are many tools, including the availability of big data. This is precisely what researchers at the University of Cincinnati did. They used data to understand who is at risk of opioid overdose in Ohio state. And they published the findings of their study in the journal Nature.

 

For the study, they analyzed the Ohio Health Department records between the years 2010 to 2017. They found that white men aged 30-39 were at high risk. Moreover, this population group was at considerable risk. The risk in men was several folds higher than in women. Similarly, they found that black men of the age were also at an elevated risk.

 

They also identified population clusters with a relatively higher risk of opioid addiction. They identified 12 hotspots in the state. These were mainly larger population groups or cities that were home to about 21% of the state’s population. These population clusters accounted for 40% of all opiate-related mortalities.

 

Researchers say that their findings are relevant in many ways. They can help guide policymakers. Not only that, but they also show the areas where agencies must focus on preventing opioid addiction. Using such data can help carry out focused efforts, like raising awareness of health hazards posed by opiate addiction, improving healthcare in those areas, and more.

 

As the researchers said that prevention is better than treatment. The primary purpose of the research is to find ways of reducing the risk of opioid addiction and overdose.

 

This data can also help scientists to understand what drives addiction in certain population groups. For example, earlier studies show that regular use of opiates reduces the production of intrinsic endorphins. Thus, a person starts feeling less excited about the daily activities and less satisfied from exercise, meeting friends, and other usual activities.
Since opiates desensitize the impact of natural endorphins, people addicted to these substances do not enjoy life as usual. Thus, they are more likely to seek pleasure in the substances. Finally, people become tolerant of opiates, and each time they need a higher dose to achieve similar results.

 

Researchers say that to counter this epidemic, health experts, educators, doctors, and public advocates, would need to come together and work.
They also noted other addiction patterns in the study, like those who had relatives addicted to opioids, were at a 10-time greater risk than others. However, researchers say there is still a need to better characterize those at a greater risk of opioid misuse.

 

Further, researchers noted that although it appears that legal opioid prescriptions contributed to this epidemic, there is more to the story. In recent years, law enforcement agencies have become stricter and even punished several doctors. However, these measures do not seem to help, as people turn to cheaper illicit drugs.

 

Suboxone is one of the drugs utilized to treat opioid addiction. However, the dose prescription must be kept under check.

 

Many of these illicit opiates, like heroin, are often laced with a cheaper and more potent synthetic drug called fentanyl. Fentanyl is a very potent drug. However, adding it to opiates significantly increases the risk of overdose. In addition, it appears that fentanyl is easier to synthesize or source.

 

This study has been limited to a single state. However, researchers think preparing such data for other states, or the whole nation would be even more helpful. Thus, in the near future, they want to conduct such a study for Kentucky and West Virginia.

 

Keeping all of the things in mind, it is better to opt for systematic, opioid addiction treatment programs.

Summary: Opioid epidemic has been ongoing for a long. However, the covid-19 pandemic has made the opioid crisis worse for many reasons. First, it appears that due to social isolation, reduced income, and other reasons, people are seeking relief from opioids. Additionally, the opioid crisis is also being made worse due to reduced attention and allocation of resources, as everyone is focusing more on countering covid-19. However, researchers warn that this would have long-term adverse consequences, causing a prolonged upsurge in opioid misuse or substance abuse disorder (SUD).

 

Opioid overdose is among the major causes of death among young adults and is a highly preventable condition. Even covid-19 epidemic would cause less mortality among healthy adults, which means that one can reduce the risk of contracting the infection through various interventions. However, those living with substance abuse disorder (SUD) are less likely to take these measures.

 

The opioid overdose epidemic has been ongoing in various parts of the US for a long time. However, in early 2020, another epidemic, or rather a pandemic, struck the world, causing millions of deaths. However, covid-19 is far from over. It is subdued but not conquered. It keeps coming back in waves as new strains keep emerging. Moreover, there is no vaccine that can protect people from covid-19 in all cases.

 

The problem is that people are more likely to see drugs during the pandemic and lockdowns. This is evident from the nationwide data. People feel more stressed and isolated, and thus they seek relief from drugs. Hence, looking for a timely opioid addiction treatment becomes a non-negotiable way out.

 

Although, covid-19 is not as significant a threat as it used to be due to mass vaccination. Nonetheless, it remains a significant public health threat. Moreover, current vaccines do not provide complete protection, and even worse, the immunity provided by these vaccines is waning in many, and they need a booster dose.

 

Opioids suppress the respiratory system, worsening covid-19 outcomes

 

Although most people may visualize opioid epidemics and covid-19 as separate disorders, that is not the case. Opioids suppress the respiratory system, harm pulmonary health, and covid-19 mainly causes lung infection.

 

Studies show that those living with SUD are at a 30% greater risk of hospitalization and are much more likely to diet due to severe covid-19 infection. In addition, many studies suggest that opioid use disorder increases the risk of contracting covid-19 by several times.

 

However, the problem is that covid-19 is only making the opioid epidemic worse. Data suggests that since the beginning of covid-19, opioid overdose-related deaths have increased in many parts of the nation.

 

Health experts worry that covid-19 pandemic is laying the grounds for the long-term resurgence of SUD. There are many reasons, including social isolation, increased mental stress, loss of employment, reduced income, and more. In addition, Covid-19 and opiate dependence is causing what researchers call “deaths of despair.”

 

Although we are confident that every covid-19 wave will weaken, this pandemic will end in the long run. However, even if this pandemic tsunami recedes, it is going to leave much damage behind, causing a resurgence in the opioid crisis.

 

These issues are not only due to stress or social isolation. Covid-19 has also disrupted SUD treatment and social support infrastructure, as everyone is focusing on controlling the more severe condition, covid-19. It means that many people living with SUD have discontinued their treatment, and now bringing them back to the clinics would require much effort.

 

Doctors say that people need to understand that the opposite of addiction is not sobriety. The opposite of addiction is connection. Unfortunately, healthcare workers and even family members have lost connection with those living with drug addiction.

 

Thus, the natural way to prevent further worsening of this condition is to start reconnecting with those living with opiate use disorder or SUD. Moreover, it is worth understanding that the opioid crisis may cause more mortalities in the long run than the current covid-19 wave. Of course, an adequate covid-19 response is essential, but it should not come at the expense of reduced attention to drug addiction.

 

Another less discussed reason for the opioid overdose epidemic is that covid-19 response has robbed healthcare workers of certain resources, as most of the sources are now being used to fight covid-19. Many of those affected by the opioid overdose epidemic see those poor policies as the significant causes driving the epidemic.