Summary: Opioid overdose-related deaths are rising in the US. Statistics show that most such deaths occur due to synthetic opioid overdose and opiate abuse, as these drugs are more potent than popular street drugs like heroin. For example, fentanyl is 50 times more potent than heroin. However, in recent years, overdose-related cases due to a new kind of opioid called Isotonitazene have been rising. This new kind of opioid is 20 times more potent than fentanyl.

Illicit drug manufacturers are becoming more complex and innovative and thus keep coming up with new drugs that are potent and cheaper to produce. The pharmaceutical industry has created most synthetic opioids with the right intention. Unfortunately, however, many of these medications have become drugs of abuse. What is worrisome is that synthetic opioids are far more potent than natural opioids.

Just take the example of fentanyl, which is a legal opiate that doctors prescribe for specific medical conditions. However, fentanyl has also become a popular drug of abuse as it is 50 times more potent than popular street drugs like heroin. However, higher potency also means a significantly higher overdose risk. Now, it appears that drug 20 times more potent than fentanyl is circulating in the illicit drug market. One need not be an expert to guess about the potential risks of such a potent drug. This drug is called Isotonitazene or commonly known as just ISO. It is a relatively new drug that has already flooded the market. Unfortunately, its rise has been exponential, and this is quite problematic.

It is a drug first identified in the illicit drug market in just 2019. In 2021, The Washington Post first reported an estimated close to 500 overdoses in the District of Columbia over the period of 12 months. The rise of this new synthetic drug is worrisome since CDC’s data show that more than 75% of overdose-related deaths occur due to synthetic opioids. Opioid addiction treatment is crucial in addressing this issue.”

This new opioid has become popular in such a short time that DEO has to offer a special warning about ISO. Basically, though the drug is new but not the phenomenon, illicit drug producers are always looking for drugs that are new, easy to produce, and potent so that they can maximize their profits. Not only that, new drugs have other benefits like Drug Enforcement Agency (DEA) and other legal bodies are not aware of the substance. Thus, a lower risk of being caught with such new drugs and an even lower risk of being persecuted. 

The law cannot persecute someone for possessing a substance that is not on a list of illegal drugs. Of course, illicit drug traders know that agencies will catch up quickly. However, they also know that they can make a lot of money in a short time. For example, though DEA now knows well about Isotonitazene, identifying the drug still remains a challenge. There are still no rapid tests available for use by the agencies. Just take the example of fentanyl. DEA or other agencies know quite well how to identify the drug. Not only that, but they also have rapid test strips to confirm. However, things are different for Isotonitazene, and thus detecting it is still challenging.

Researchers say that these days one can readily buy various chemicals online that are labeled as “not for human consumption.” Many organizations sell these chemicals for scientific studies. However, some illicit drug makers can get hold of such substances and even learn to produce them, which results in the introduction of new drugs to the market. Of course, it is better to avoid substance use altogether to stay safe. However, for those with substance abuse disorder, it is better to avoid using new substances, as using such substances poses a much greater threat.

The Bottom Line

Addictionology Center offers a dedicated opioid addiction treatment for its patients depending upon their condition and medical history. With its comprehensive approach, our Telemedicine Addiction treatment program helps to get the best of treatment right in the comfort of your home. Schedule an appointment today to get in touch with the experts.

Summary: Opioids are not prescribed in pregnancy. However, so many people are living with opioid use disorder (OUD). Thus, it is no surprise that many pregnant women are exposed to opioids. Opioid Use Disorder (OUD) causes many pregnancy-related complications like increased risk of preterm birth. However, now a study shows that opioid exposure during pregnancy also results in a smaller fetal brain. Thus, OUD may have long-term implications for children born to women living with OUD.

Doctors are unlikely to recommend opioids during pregnancy. However, about 2.7 million people are living with opioid use disorder symptoms (OUD) in the US alone. The vast majority of them are addicted to prescription opioids and some to street drugs1. Hence, many fetuses are exposed to opioids in their early life.

Fetuses, that is, unborn offspring, differ from adults. It is a stage when an organism is growing fast, and body structures are still forming. Thus, a kind of side effects would also differ in pregnancy. Opioid exposure not only harms women’s health but may also cause significant harm to fetal development.

There are many studies focused on the harm of OUD during pregnancy. Studies show that it results in preterm birth, stillbirths, higher maternal mortality, and more. However, there are still very few studies regarding the impact of opioid exposure during pregnancy and fetal brain development.

The new study published in the American Journal of Roentgenology found that opioid exposure leads to poor fetal brain development. Thus, women exposed to opioids during pregnancy have fetuses with smaller brains compared to those not exposed to opioids.

The study was done at multiple centers in the US. Doctors included those women in the study who had to undergo MRI in their third trimester. During the investigation, they marked the women as either opioid exposed or not exposed to opioids. 

A total of 28 fetal scans were of opioid-exposed women, and 37 fetal scans were of unexposed. When they corrected for fetal age and other confounding factors, they found that fetuses exposed to opioids had significantly smaller brain sizes than those unexposed. They also found increased amniotic fluid volume (29% vs. 8%) and a considerably higher risk of breech position.

This study shows the magnitude of the problem of health threats posed by OUD. However, it should not be viewed merely as a condition causing overdose deaths or few pregnancy complications. Its harms may be even graver, and many harms are challenging to measure.

Smaller brain size is just one thing. However, it is quite challenging to measure how due to OUD, each year, hundreds of children are being born that may experience various disabilities later in their life.

It shows how OUD may influence generations to come. Children born to parents living with OUD may have numerous mental health issues, neurodevelopmental issues, a higher risk of physical ailments, and more.

This study has just explored the tip of the iceberg. Nonetheless, it is a study in the right direction. It shows that statistics regarding drug addiction, related disabilities, and mortality do not show a complete picture.

It also shows the vitality of treating OUD symptoms in young adults. By treating these disorders, we are helping young adults and doing a great service to the coming generation. 

Additionally, it also shows that clinicians should be careful prescribing opioids to young adults, especially women of childbearing age. There is also a need to increase awareness regarding health threats posed by opioid abuse in young adults, especially those planning to have a child.

Additionally, this study should form the basis for further studies into the topic. There is also a need to explore health issues in children born to parents living with OUD. This will help provide timely help to these children.

Summary: Doctors are more likely to prescribe opioids to those living with chronic pain. Thus, these are also people more likely to develop OUD. A new study shows that these are individuals living with a peculiar kind of problem called central sensitization. Such individuals are more likely to suffer from chronic pain and respond poorly to pain treatment, and thus at a greater risk of OUD.

It is no secret that those living with chronic pain are more likely to be prescribed opioids, and thus such people are also more likely to develop pain medication addiction. However, the relationship between OUD and chronic pain is as casual as it may sound. 

There are many people for whom doctors prescribe opioids for their chronic pain, and yet only some develop OUD. Therefore, there is a need to understand the link between the two. Researchers could identify one potential mechanism in one of the first of its kind of study. They found increased central sensitization among those living with OUD.

Central sensitization is a unique issue affecting many chronic pain patients. In this condition, individuals have a spinal cord that is exceptionally good at sending pain signals to the brain. Consequently, their brain struggles to overcome these pain signals and becomes sensitized. Hence, such people are more likely to suffer from pain and have a low pain threshold.

In the first of its kind of study, researchers used a special scale to measure central sensitization in those living with OUD. It is the first study to demonstrate that those living with OUD or opioid addiction have central sensitization.

This latest study was published in the journal Pain Reports. In the study, researchers enrolled 141 patients living with OUD and being treated for opioid addiction. In the study, they had to answer questions regarding their pain, quality of life, pain beliefs, and more. These questions helped researchers understand central sensitization in such patients1.

People living with chronic pain are more likely to be living with OUD. At the same time, those living with chronic pain also have difficulty living without opioids. Thus, they are at significant risk of developing opiate dependence and living with OUD. In addition, researchers found that those living with OUD had worse quality of life, more difficulty controlling chronic pain, and greater central sensitization.

People living with central sensitization were more likely to seek pain treatment and prescribed opioids for their pain. Unfortunately, this is often the beginning of opioid addiction for many such individuals. Moreover, in these people, pain is more likely to persist for a long time and have treatment relapses, which further adds to the opioid dependence risk.

Therefore, researchers say that central sensitization may significantly complicate OUD treatment. However, it also means that clinicians should measure central sensitization in those living with opioid addiction to treat OUD successfully.

One of the issues why this problem often remains neglected is that very few physicians specialize in pain and addiction treatment. Hence, most patients continue to receive treatment for these conditions separately. 

Nevertheless, there are some specialists in the US that specialize both in pain and Opioid addiction treatment. However, health experts warn that, at present, there are very few treatment options for those living with central sensitization and OUD. It means that doctors need to explore different treatment approaches in those living with OUD, including non-pharmacological means.

Addictionology Center in St Louis provides a holistic set of services to treat chronic pain as well as medication for opioid use disorder. It has its telemedicine addiction treatment program along with suboxone treatment to provide you with the facilities in the comfort of your home.

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: Those living with opioid use disorder are generally hesitant to seek medical help. However, covid-19 epidemic has only made things worse. Thus, policymakers legalized providing medical care to those living with OUD via telehealth. However, there have been some concerns regarding the decision. The new study shows that telehealth is beneficial for those living with OUD and is associated with a reduced risk of overdose events. This underscores the importance of telehealth in providing treatment and care for opioid addiction treatment.

The scale and extent of covid-19 pandemic took everyone by surprise. The world was not ready for the pandemic. This created many challenges. It made providing medical help to a specific group of patients more difficult. Moreover, due to covid-19, people got confined to homes and traveled less often. It also means that covid-19 related restrictions created a barrier to seeking medical help.

 

It is no secret the those living with opioid use disorder (OUD) are less likely to seek medical help. There are many reasons, from social stigma to disbelief in the system. For such individuals, things became even more difficult during the pandemic times.

Fortunately, US policymakers realized this challenge faced by people living with OUD and legalized telehealth for OUD. It means that for the first time, doctors could legally prescribe opioids used to manage OUD without seeing a patient. However, this change in policy was not well received by everyone. Many were skeptical of such a change and worried that it might even make the ongoing opioid overdose epidemic worst, as opioids would become more accessible for many.

Fortunately, a new study shows that these policy changes have been beneficial and resulted in reduced risk of overdose. The study was carried out by researchers from CDC, NIDA, NIH, and CMS. The results of the study were published in the journal JAMA Psychiatry.

In the study, researchers analyzed the data of 175,778 Medicare beneficiaries from September 2018 to February 2021. They focused on analyzing the events of an overdose in those who received medications for opioid use disorder (MOUD) through telehealth during the pandemic.

They had several interesting findings:

• They found that there was a sudden upsurge in people seeking telehealth services for OUD. Thus, these numbers increased from 0.6% to 19.6% during the pandemic.
• Interestingly, they also found that people receiving telehealth care were more likely to receive MOUD, which was 12.6% for telehealth. In contrast, these numbers were 10.8% for those who visited the doctors.
• Telehealth services had many positive effects on patient care. Thus, those treated for OUD were more likely to stick to their treatment. In addition, patients were less likely to overdose on their drugs.

Researchers say that their findings show that telehealth services helped overcome the barrier to medical care for addiction. This barrier to seeking medical help is among the most important reasons why many do not seek medical help. Lack of treatment and support naturally means a greater risk of a drug overdose. 

Researchers say that there is clear evidence of the benefit of telehealth. It is not just good for patients; it can be lifesaving for many. In addition, it is clear that telehealth can have many long-term positive effects on patients.

The study also noted some disparities due to an existing digital divide. Thus, non-Hispanic black people were less likely to seek tele help. Therefore, countering this digital divide is vital for fully exploiting the benefits of telehealth.

Researchers say that though the covid-19 pandemic has created many challenges for the healthcare system, it has also provided opportunities for investigating various ways of providing healthcare.

To sum up, this study is supportive of telehealth for OUD, and it shows that these services must be continued even in the post-pandemic era. 

Summary: Opioid crisis and opiate abuse have only worsened in recent years, despite declining rates of opioid prescription. It is no secret that many people living with OUD are not seeking treatment. There are many causes for people not seeking treatment, like clinics not taking new patients, or many are just hesitant to seek treatment. However, telemedicine now offers hope. Doctors can not only treat OUD through online apps or platforms but also prescribe drugs like suboxone, which is a combination of buprenorphine and naloxone.

It is no secret that there are many reasons why so many people are not getting OUD treatment. One of the reasons is that there are just not enough clinics and specialists to treat the condition. In addition, many clinics are not taking new patients, and there are long waiting times.

Another, perhaps, even more significant reason is that those living with any kind of addiction do not want to go to clinics. There is much hesitance. They think that others would not understand their problem or simply do not want to travel, seek help, and more.

However, what if we said that now you can get opioid treatment programs online and prescription for medications? Finally, many states have approved the use of telemedicine in treating OUD. It is the right step, considering the scale of the problem.

Moreover, for most people living with opioid addiction, privacy is also a significant reason for not seeking help. Now they can expect to get treatment in the privacy of their home and even expect to get prescription medication.

Many clinics have now launched online OUD treatment services, which are completely legal. But, of course, there are some requirements to be fulfilled. For example, DEA has made it necessary that patients should undergo live video interviews with healthcare providers and not consult via chat. These limitations are just for the first time, as later, one can keep in touch with the clinics through other means.

Currently, a drug called suboxone is approved for treating addiction through telemedicine. It means that doctors can prescribe this to those living with OUD without the need to visit a clinic. It is among the most effective drugs to treat OUD, and it is a combination of buprenorphine and naloxone.

Suboxone is a very interesting medication and quite effective due to its unique mode of action. For example, buprenorphine works almost in the same way on opioid receptors as oxycodone. However, its activity is much less. Naloxone, on the other hand, blocks the effects of opioids.

Generally, naloxone is not used along with opioids like medications due to the risk of some severe side effects. However, it seems that combining it with buprenorphine is safe and good. Such a combination help overcome withdrawal syndrome quite effectively and, at the same time, block some of the unpleasant effects of prolonged opioid use. Hence, it is among the most effective ways to recover.

Online suboxone prescription is legal, but not in all states. Thus, if you are looking for a suboxone treatment option, you would need to check if online it is legal in your state. Of course, it is worth understanding that things are changing fast, and it is becoming legal in an increasing number of states. Thus, checking the latest information is always a good idea.

Of course, there are some other limitations of this kind of treatment. Besides the first online video interview, doctors would regularly ask you to get tested for opioid use. They would often send you a testing kit, and you will need to carry out the required tests, or else doctors can stop prescribing suboxone. These are some of DEA’s strict requirements, and everyone must stick to them.

Here it is vital to understand one more important thing; if suboxone online prescribing is legal in your state, it does not mean that just any doctor can prescribe it. Buprenorphine is still a controlled substance; thus, clinicians need to obtain a special waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA).

Moreover, to avoid any pain killer addiction, there has to be a strict dosage prescription policy , both by the patient and the doctor.

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: Chronic pain is among the most common comorbidities in those being treated for opioid use disorder (OUD). However, a new study found that in most cases, doctors treating OUD do not pay sufficient attention to chronic pain management, resulting in higher opioid relapse. They also found that those treated with medications like methadone or buprenorphine had better pain relief and, thus, better treatment outcomes. Therefore, researchers recommend that doctors focus on managing comorbidities when treating OUD.

When we think of people living with OUD, we completely neglect that many of them live with severe chronic pain such as, neck pain, complex regional pain syndrome, etc. This poorly managed chronic pain may be related to poor treatment outcomes in many. Studies show that chronic pain is the most common comorbid condition in those living with OUD.

 

Recently, the Journal of Pain published a patient survey, finding that two-thirds of those treated for OUD reported that their chronic pain was not managed well. Even worse, 47% reported that their pain worsened over time, thus increasing the risk of opioid relapse.

 

The opioid crisis continues to be a significant health problem, and it is showing no sign of slowing down. Moreover, the coronavirus pandemic only increased opioid use disorder (OUD) and drug overdose-related deaths. This only underlines the need to pay more attention to the effective opioid addiction treatment.

 

Health experts say that the problem in tackling the opioid crisis is not just in lack of access to opioid treatment, which is true. Still, other factors make treatment more difficult and result in high relapse rates. In addition, most people treated with OUD have other comorbidities, with many living with mental health issues and chronic pain.

 

Although it is no secret that chronic pain and OUD are related health issues. However, it is unknown how ill-managed pain in those living with OUD may affect treatment outcomes for the condition. Health experts say that one of the problems is that treating doctors focus significantly on OUD, but less on comorbidities, especially issues like chronic pain.

 

In the new survey, researchers analyzed the data of 14,449 patients getting treated in 225 OUD treatment centers. They found that one-third of all the patients had significant chronic pain. Out of these patients, just one-third reported that their chronic pain was managed properly with pharmaceutical drugs. Moreover, almost half of all the patients said the pain was the primary reason for opioid relapse.

 

Researchers say this is a massive sample size, and they were amazed to see that so many patients are not being treated adequately for their chronic pain. Many of these patients have even used street drugs like heroin to manage their pain.

 

When researchers interacted with doctors treating OUD, they were often told that treating pain was not their priority or not within the scope of their practice.

 

Researchers say that there is a need to understand that pain is among the most significant causes of opioid relapse. Hence, effective treatment of OUD must include adequate pain relief.

 

The study had another unexpected finding related to opioid relapse. In the survey, 20% of those treated for OUD said that they would return to opioid use once they overcame their addiction. It means that treatments are not preparing them well for post-treatment life, and many of them still view opioid use as an option.

 

The study also found that those treated with OUD with medications had a higher success rate. Thus, those treated with buprenorphine and methadone reported better treatment satisfaction. It seems that one of the reasons for a greater success rate with these medications is that they also help with chronic pain treatment.

 

Thus, health experts say addiction treatment will only improve if different health specialists work together. Moreover, the coronavirus pandemic has shown that interdisciplinary collaboration using technologies like telemedicine is not that difficult.

 

Of course, researchers say that the study has also raised certain questions, like the role of opioids in pain management. As a result, the researchers suggest that the use of opioids for managing chronic pain should be limited.

 

Additionally, researchers say that one of the issues is that doctors often do not view chronic pain as one of the significant issues. They forget that this pain may be due to comorbidities like depression and mood disorders requiring treatment. If these comorbidities remain unmanaged, relapse is more likely.

 

Hence, researchers concluded that OUD should be treated by multi-specialist teams, including pain management, psychiatry, psychology, integrative medicine, and physical therapy. In addition, we should treat the patient as a whole and not merely focus on reducing pain numbers on a scale.

Summary: Despite a decline in opioid prescriptions, the opioid crisis continues. Opioid use disorder (OUD) and deaths due to opioid overdose continue to increase. Thus, researchers say that there is a need to develop a better understanding of opioid dependence and avoid oversimplification of the problem. So though an increase in opioid prescriptions initially fueled the crisis, later, other factors came into play, like pill mills and an increased supply of illegally produced opioids. 

The opioid crisis is not new, but it is not showing any signs of fading despite the best efforts of regulatory agencies and medical practitioners. What is worrisome is the upward trend of opioid overdose-related deaths, despite a significant decline in opioid prescriptions in the last few years. In addition, it appears that many are now procuring and using prescription opioids produced illicitly. 

Researchers think that if we want to counter this crisis, we need to understand the complex nature of the opioid crisis. Things are not as simple as they might appear. This crisis is not fueled much by opioid prescriptions by doctors to manage chronic pain. Instead, there are other factors like pill mills and “unscrupulous” physicians fueling opioid use disorder (OUD). This pathway that is fueling OUD exists outside the domain of chronic pain management. 

Though there are indeed many faces of the opioid crisis, and it is among the most complex health crisis causing physical and psychiatric health issues. Still, it is also worth understanding that the drug landscape is continually changing. Therefore, what researchers warn is against the oversimplification of the problem. 

For example, saying that the epidemic is solely fueled by opioids prescribed to manage chronic pain is just an oversimplification. On the contrary, studies show that when opioids are prescribed for managing chronic pain, very few patients abuse these drugs. Hence, opioids prescribed by doctors to manage chronic pain do not contribute much to OUD.

Similarly, initially, this factor played a role in OUD development since prescription drugs were cheaper options. However, this factor is not relevant anymore. Though pill mills continue to contribute to the crisis, they are not the only source.

It is true that initially, opioid prescription played a significant role in the opioid epidemic. The epidemic had a humble beginning, as the doctors wanted to help their patients living with chronic pain. Thus, they started prescribing opioids to many patients. However, soon opioid demand rose, and many started procuring these drugs from the illicit market. Due to high demand, the market got filled with illegal drugs. This also affected the market for illicit drugs as it shifted from heroin from Asia to illicitly produced fentanyl in Latin America.

However, researchers say we cannot blame pill mills and unscrupulous physicians alone. Many hospitals continue to prescribe opioids even for conditions with little benefit from opioid prescriptions. 

Since the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain, opioid prescriptions have fallen. Nonetheless, opioid prescriptions remain relatively high in the US compared to other nations worldwide. In addition, studies now confirm that 90% of those living with OUD often use these drugs for non-medical reasons.

Though studies suggest that very few people prescribed opioids for chronic pain will ever develop OUD, this is still a significant number. Moreover, studies show that the number of people older than 50 seeking treatment for OUD has continuously increased. People of this age group are more likely to source opioids from physicians.

Similarly, it is still poorly understood why some individuals are more likely to develop OUD. Nonetheless, researchers think that there is no single explanation. Most of those who develop OUD are individuals who already have other psychiatric comorbidities apart from chronic pain. Thus, this group of people is more likely to develop OUD. Consequently, they not only keep using prescription opioids but are also pretty likely to buy illicit drugs.

To sum up, the researcher says that though specific techniques like using electronic health record notification and motivational interviewing along with opioid dependence treatment  may help reduce the risk of OUD, much work still has to be done to understand the causes of OUD.

It is our mission to bring real hope and transformational change to patients who would otherwise be consigned to a lifetime of medications for opioid addiction treatment, doctor’s visits, and suffering. We expose misaligned incentives and return the power of health to the individual. We believe empowered individuals change their communities. We use a combination of lifestyle intervention, medication management, and emerging scientific research to help our patients.  When you are ready or have questions, reach out.

Medical Disclaimer: Keep in mind that the content provided is not direct medical advice for patient care, but is provided for thoughtful discussion.