State of the Opioid Abuse and Overdose Crisis in America
According to the CDC's National Vital Statistics System, more than 130 people in the United States die after overdosing on opioids each day.
The misuse of and addiction to opioids, including prescription pain relievers, heroin, and synthetic opioids such as fentanyl is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
Opioid overdose rates began to increase. In 2017, more than 47,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder.
National Institute on Drug Abuse Statistics Show that roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them, and that between 8 and 12 percent develop an opioid use disorder. An estimated 4 to 6 percent who misuse prescription opioids transition to heroin, and about 80 percent of people who use heroin first misused prescription opioids.
Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017, and overdoses in large cities increase by 54 percent in 16 states.
This issue has become a public health crisis with devastating consequences including increases in opioid misuse and related overdoses, as well as the rising incidence of neonatal abstinence syndrome due to opioid use and misuse during pregnancy. The increase in injection drug use has also contributed to the spread of infectious diseases including HIV and hepatitis C. As seen throughout the history of medicine, science can be an important part of the solution in resolving such a public health crisis.
In response to the opioid crisis, the U.S. Department of Health and Human Services (HHS) is focusing its efforts on five major priorities:
1.) improving access to treatment and recovery services
2.) promoting use of overdose-reversing drugs
3.) strengthening our understanding of the epidemic through better public health surveillance
4.) providing support for cutting-edge research on pain and addiction
5.) advancing better practices for pain management
The National Institutes of Health (NIH), a component of HHS, is the nation's leading medical research agency helping solve the opioid crisis via discovering new and better ways to prevent opioid misuse, treat opioid use disorders, and manage pain. In the summer of 2017, NIH met with pharmaceutical companies and academic research centers to discuss safe, effective, non-addictive strategies to manage chronic pain along with new, innovative medications and technologies to treat opioid use disorders, and improved overdose prevention and reversal interventions to save lives and support recovery.
In April 2018 at the National Rx Drug Abuse and Heroin Summit, NIH Director Francis S. Collins, M.D., Ph.D., announced the launch of the HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. To obtain more information and helpful resouces for your practice, please see the HEAL Initiative Research Plan at https://heal.nih.gov/about/research-plan
The CDC has also released guidelines for prescribing Opioids for Chronic Pain that are available at https://www.cdc.gov/mmwr/volumes/65/rr/pdfs/rr6501e1.pdf