Are Opioids Helpful or Harmful?
According to a report released in November 2017 by The Council of Economic Advisers, an agency within the Executive Office of the President, the opioid crisis cost the economy $504 billion in 2015. The council plans to assess the economic viability of proposed and actual interventions to abate the crisis in the near future. Yet despite the attention given to the “Opioid Epidemic” in the media, many people are unsure of the implications for the use of opioids in treating patients.
What are opioids?
Opioids are a type of drug that acts on opioid receptors that are naturally found in the human body. The effect of opioids varies from drug to drug, but opioids in general are most commonly used to help manage pain.
For pain management, opioids are undoubtedly effective. For short-term pain, such as pain resulting from an injury or surgery, opioids are often recommended because of their many benefits. These include:
- Effective pain relief
- Fast-acting pain relief
- Reduced risk of addiction compared to other effective short-term pain relievers
Opioids are also sometimes recommended for long-term pain. Cancer patients are often treated with opioids to treat the pain associated with cancer and cancer treatment. In fact, this use of opioids is recommended by the world health organization.
Why are opioids controversial?
Although they are very effective at managing pain, opioids are controversial because they are addictive. If a patient develops a tolerance to opioids and becomes addicted, several negative outcomes are possible:
- Use of harder drugs
- Withdrawal, which can be fatal
Opioid withdrawal is extremely dangerous, and overdose can be fatal. The increase in opioid-related deaths and addiction has led to the declaration of an opioid epidemic.
What caused that epidemic? The answer is multifaceted, but most agree that the primary causes include over-prescription of opioids and use of opioids to manage chronic pain not related to cancer.
When patients are unnecessarily prescribed opioids, there is a greater chance that some patients will become addicted. When opioids are used to manage chronic, non-cancer pain, patients are more likely to become addicted and develop a tolerance over time, which in turn increases risk of overdose.
Are opioids helpful or harmful? It depends. Opioids can be very effective to manage short-term pain or pain caused by cancer. At the same time, opioids should not be used if they are not necessary, and chronic use can cause chronic problems.
What is being done about the opioid crisis?
The report outlining the economic impact of the opioid crisis has come just weeks after President Trump declared the crisis a public health emergency, but he has as yet neglected to directly allocate federal funding for the epidemic. According to the New York Times, early data from 2017 suggests that drug overdose deaths will continue to rise this year. The report authors have urged Congress and the Administration to block grant federal funding for opioid-related and SUD-related activities to the states. According to STAT News in November, Administration officials have said they expect the opioid crisis to figure into budget negotiations and a spending bill Congress must pass by December.
- The opioid epidemic refers to the increased use and abuse of opioids, with negative consequences including withdrawal and overdose.
- Opioids can be effective for short-term pain management or managing long-term cancer pain, but over-prescription and use for other long-term pain may be contributing to the epidemic.
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