The United States is in the midst of a significant opioid addiction crisis, with the White House declaring that combating opioid dependence is a top priority of the administration. Misuse of prescription opioids represents the bulk of the opioid epidemic. Now, new evidence shows that Americans use an astonishing 80% of the global supply of opioids, including 99% of the global hydrocodone (e.g., Vicodin). Understanding the source of this pattern of opioid use can help to combat addiction to prescription opioids and help patients receive effective hydrocodone addiction treatment, such as hydrocodone rapid detox.
The heroin epidemic gained prominence in the 1980s, with the federal administration declaring a War on Drugs that has had reverberating effects on drug policy decisions. However, the current opioid epidemic is much more a problem of prescription drug abuse than heroin abuse. An estimated 2.1 million Americans currently are struggling with prescription drug abuse, compared to 467,000 people affected by heroin abuse.
A large part of the prescription opioid epidemic is fueled by physician prescribing practices. After cancer medicines, painkillers are the most commonly prescribed class of medications worldwide.
In an attempt to curb physician overprescribing of opioid painkillers, the Centers for Disease Control and Prevention recently released prescribing guidelines. The guidelines recommend that prescriptions limit an initial prescription to just three days, long enough to curb acute pain after surgery or injury. However, an estimated 99% of physicians exceed that recommended three-day dosage limit. The easy availability of opioid painkillers makes it easy for patients to begin misusing these medications to dull the psychological or emotional pain they may be experiencing. This soon leads to addiction and drug dependence.
How Prescription Opioids Cause Addiction and Dependence
Any prescription opioid painkiller can be potentially abused. However, these prescription drugs vary in their potency, availability, and additive potential. Opioid painkillers cross the blood-brain barrier, allowing them to permeate the brain’s blood supply. Once there, they bind to mu opioid receptors in the brain, diminishing the pain response.
At the same time, however, the opioids attach to receptors in the limbic system of the brain. The limbic system governs reward, making it more likely that a person will take opioids again because of their rewarding side effects. Taking opioids over a period of time can cause the reward circuitry of the brain to change in structure, causing compulsive drug-seeking. This behavioral pattern of drug seeking is what is known as drug addiction. Many people addicted to opioids first begin misusing the drugs in an attempt to dull emotional or psychological pain.
In addition to causing addiction, prolonged use of opioids may lead to drug dependence. Drug dependence refers to the physiological need for the drug. There are two main features of opioid dependence: withdrawal and tolerance. Withdrawal refers to the physiological side effects that occur if the drug is no longer taken. Tolerance, on the other hand, refers to the need to take more and more of the drug to get the same effect. Together, opioid dependence and addiction make it difficult for people to stop using prescription drugs.
Commonly Abused Prescription Opioids
Any form of prescription opioids can lead to physical dependence or addiction. Some of the most commonly abused prescription opioids in the United States are oxycodone (e.g., Oxycontin) and hydrocodone (e.g., Zohydro, Hysingla). These medications significantly reduce pain as well as inducing euphoria. Unfortunately, they also make it more likely that a person will become addicted to the drug.
The approach to combating the U.S. opioid epidemic must be multifactorial. Physicians should adhere to prescribing guidelines by limiting opioid prescriptions to the people who truly need them. For example, Americans use 99% of the hydrocodone on the world market. This means that patients also need access to effective treatments for hydrocodone dependence. Hydrocodone rapid detox protocols that take place in a medically supervised hospital environment can help patients overcome the often challenging withdrawal symptoms. This leaves them in a better position to pursue treatment to overcome the behavioral addiction that keeps them returning to drugs. By incorporating access to hydrocodone dependence treatments such as hydrocodone rapid detox, we can make headway against the U.S. opioid epidemic.
America’s Addiction to Opioids: Heroin and Prescription Drug Abuse, Senate Caucus on International Narcotics Control. Retrieved on 05/09/2016.