There is an epidemic that is killing tens of thousands of Americans and has recently been surging throughout the country. I’m not talking about COVID-19. It is the opioid epidemic.
The opioid crisis is not new, but the COVID-19 pandemic has made it worse. The epidemic of opioid-related deaths in the United States saw three waves in the pre-COVID era. The first wave was a rise in prescription opioid-related overdose deaths, which began in 1999. The second was a rise in heroin overdose deaths, which began in 2010. The third was a rise in synthetic opioid overdose deaths, which began in 2013.
The majority of drug overdose deaths in the past two decades in the United States have been from opioids. According to the Centers for Disease Control and Prevention, in the 20 years that directly preceded the COVID-19 pandemic, which began in 2019, more than 500,000 people died from an opioid overdose, including prescription and illicit opioids. In the last year, according to recently released data, more than 100,000 additional people have died from an opioid overdose, the largest single number of annual overdose deaths to date.
Opioids, sometimes referred to as narcotics, including both naturally occurring and human-made substances that act on the central nervous system. Natural opioids are derived from the opium poppy. Prescription opioids are those approved for use in the management of pain, such as from severe injury or surgery. The first wave of opioid overdose deaths in the United States resulted from the over-prescribing of these medications.
Partially synthetic and fully synthetic opioids include both prescription and illicit substances. The synthetic opioid, fentanyl, which is produced both for medical use and illicitly, has fueled the recent rise in overdose deaths. Because of both its high potency and the fact that it is commonly found in combination with heroin, counterfeit pills and cocaine, fentanyl is particularly dangerous.
Opioids are highly addictive substances, and anyone can become addicted. They change how the brain functions. When taken in too high of a dose and/or combined with other substances such as alcohol or other drugs, they can alter the level of consciousness, slow breathing and cause death.
In addition, opioids can cause other major side effects, including tolerance, physical dependence, sleepiness, confusion, depression, itching, constipation and loss of sex drive.
There are effective treatments for opioid addiction. These include medication-assisted treatment, which is designed to address cravings, as well as mental health services to help overcome addiction and deal with coexisting problems, such as depression and anxiety. Harm reduction strategies, such as the training of family and friends in use of the reversal agent, naloxone, can reduce the risk of overdose death.
People who are misusing and/or addicted to opioids should talk to their doctor to find treatment. For those seeking help, the U.S. Substance Abuse and Mental Health Service Administration also has an online treatment finder tool at https://findtreatment.samhsa.gov.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
