Opiate painkillers like oxycodone and hydrocodone are potent medications. When used as directed for a finite time, they can be effective in helping to manage pain that might otherwise be overwhelming. But when they are taken without a prescription, used in combination with alcohol or other illicit substances, or taken in large amounts, they can become a part of an addiction disorder and/or trigger a deadly overdose.
In Louisiana especially, the problem of abuse of painkillers is particularly prevalent. A new report shows that there are more prescriptions than there are people in the state. That is, there are 1.03 painkiller prescriptions for every Louisiana resident. It is one of eight states in the nation that has more painkiller prescriptions than people.
Dr. David Holcombe is the medical director of the Office of Public Health Region VI in Central Louisiana. He said: “This has been a disaster almost created and then perpetrated. It’s driven by pharmaceutical greed, physicians prescribing, and patient demand. We have been building to this.”
But it is not just the use of prescription painkillers that is wreaking havoc in the lives of Louisianans. It is the use of all opiate drugs. According to the Drug Enforcement Administration (DEA), heroin laced with synthetic fentanyl is the biggest drug threat in the city of New Orleans. Since the beginning of the year, more than 65 deaths have been attributed to use of these drugs, a number that has steadily increased since 2014.
One of the trademark characteristics of addiction disorders is compulsive engagement in a range of behaviors. Using drugs, drinking, gambling, having sex, shopping, eating – there are any number of behaviors that may fall into this category, and they all can signify an ongoing struggle with addiction. An individual may realize that there is risk – deadly risk – associated with drug and alcohol use yet still drink or get high. Similarly, it may be understood that unprotected sex with a stranger can result in disease or that continually binge eating high-fat, high-sugar items will lead to obesity, which in turn will lead to deadly chronic diseases and an increased risk of certain cancers, but when addiction is present, reason exits and compulsivity takes over.
In treatment, learning how to manage compulsive behaviors is a big part of comprehensive care. It is a process to get to a point where your first inclination is not to engage in the behavior of choice, but this begins with:
- Stopping all use of drugs and alcohol
- Stopping engagement in other process addictions (e.g., gambling, shopping, etc.)
- Learning how to manage compulsive behaviors that are necessary for a healthy life (e.g., eating)
- Learning new ways of coping with stress, boredom, anger, and other emotions that may trigger compulsivity
- Getting treatment for underlying conditions like PTSD, mood disorders, and chronic pain
The Opioid Epidemic in Louisiana
The opioid epidemic has been a growing problem in the United States, and Louisiana has not been spared. The state has seen a significant increase in opioid-related deaths in recent years. The CDC reported that in 2017, there were 444 opioid-related overdose deaths in Louisiana. That's a rate of 9.6 deaths per 100,000 persons, which is higher than the national average of 14.6 deaths per 100,000 persons.
The Impact of Painkiller Prescriptions
Painkiller prescriptions are often prescribed for chronic pain, but they can also be highly addictive. When not taken as prescribed, painkillers can lead to addiction, overdose, and even death. The CDC reports that nearly 50% of opioid-related overdose deaths involve a prescription opioid.
The high rate of painkiller prescriptions in Louisiana is alarming, but it's not just a Louisiana problem. The opioid epidemic has affected many states across the United States.
Addressing the Problem
Despite the severity of the problem, efforts are being made to address the opioid epidemic in Louisiana. The state has implemented a Prescription Monitoring Program (PMP) to help prevent prescription drug abuse. The PMP monitors the prescribing and dispensing of controlled substances to patients. This program helps identify patients who may be at risk for addiction and allows physicians to make informed decisions when prescribing painkillers.
Moreover, Louisiana has also implemented a Good Samaritan Law that provides immunity from prosecution for certain drug offenses to individuals who seek medical assistance for someone experiencing an overdose. This law encourages individuals to seek help without fear of legal consequences.
The Role of Healthcare Providers in Preventing Opioid Addiction
Healthcare providers play a crucial role in preventing opioid addiction. They are on the front lines of patient care and have the responsibility of ensuring that their patients receive appropriate pain management while minimizing the risk of addiction.
Preventing opioid addiction
One way healthcare providers can prevent opioid addiction is by using alternative methods to manage pain, such as physical therapy, acupuncture, or non-opioid medications. They can also make sure to prescribe opioids only when necessary and for a limited time period.
Another important step healthcare providers can take is to educate their patients about the risks associated with opioid use and how to safely use these medications. This includes making sure patients understand the importance of taking medications exactly as prescribed, not sharing medications with others, and properly disposing of unused medication.
Furthermore, healthcare providers should be aware of the signs of opioid addiction and be prepared to intervene if they suspect that a patient may be struggling with addiction. This could involve referring them to a specialist for further evaluation or providing resources for substance abuse treatment.
In short, healthcare providers have an important role to play in preventing opioid addiction. By using alternative methods to manage pain, educating patients about safe medication use, and being prepared to intervene if necessary, they can help reduce the number of individuals who become addicted to opioids.
The Impact of the Opioid Epidemic on the Economy and Workforce
The opioid epidemic has a significant impact on the economy and workforce, in addition to individuals and their families.
According to a recent report by the National Safety Council (NSC), the opioid epidemic cost the United States economy $696 billion in 2018 alone. This includes costs related to healthcare, criminal justice, lost productivity, and more.
One of the ways in which the opioid epidemic impacts the workforce is through decreased productivity. Employees who are struggling with addiction may miss work or be less productive while at work due to their substance use. This can ultimately lead to increased absenteeism, presenteeism (being physically present but not fully functioning), and turnover rates for businesses.
Moreover, employers may also face higher healthcare costs associated with treating employees who are struggling with addiction. In addition, they may have to cover costs related to workers' compensation claims for injuries sustained due to impaired judgment or motor skills as a result of drug use.
Overall, the opioid epidemic has far-reaching consequences that extend beyond individual patients and healthcare providers. It is important for policymakers, business leaders, and other stakeholders to recognize these impacts in order to develop effective solutions that address both individual needs and broader economic concerns.
Alternative Pain Management Strategies for Chronic Pain Patients
For chronic pain patients, there are alternative strategies that can be used to manage pain without relying on opioids.
- Physical therapy: Physical therapy is one such strategy that has been shown to be effective in managing pain. This can include exercises and stretches to improve mobility and reduce pain levels.
- Acupuncture: Another alternative strategy is acupuncture, which involves the insertion of thin needles into specific points on the body. Acupuncture has been found to be effective in reducing pain levels for some patients.
- Non-opioid medications: Non-opioid medications can also be prescribed for chronic pain management. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or other types of medications like antidepressants or anticonvulsants.
In addition to these strategies, lifestyle changes can also be made to help manage chronic pain. This may include:
- Diet modifications
- Stress reduction techniques such as meditation or yoga
- Getting enough sleep
It's important for healthcare providers to work with their patients to identify the best approach for managing their chronic pain. By exploring these alternative strategies and making lifestyle changes when appropriate, patients may be able to reduce their reliance on opioids while still effectively managing their chronic pain.
The Stigma Surrounding Addiction and Its Impact on Treatment
One of the major barriers to addressing the opioid epidemic is the stigma surrounding addiction. Individuals who struggle with addiction are often stigmatized and blamed for their condition, which can lead to a lack of understanding and support from society.
This stigma can also impact treatment options for individuals struggling with addiction. Many people may be hesitant to seek help due to fear of judgment or discrimination. This can prevent them from accessing necessary treatment such as medication-assisted treatment (MAT) or counseling services.
Moreover, healthcare providers may also hold negative attitudes towards individuals struggling with addiction, which can impact the quality of care they receive.
Impact of stigma
- Lower quality of care: Healthcare providers may be less likely to prescribe MAT or refer patients to substance abuse treatment programs if they hold negative attitudes towards addiction.
- Reduced access to treatment: Many people may be hesitant to seek help due to fear of judgment or discrimination. This can prevent them from accessing necessary treatment such as MAT or counseling services.
It's important for individuals, healthcare providers, and society as a whole to recognize that addiction is a disease that requires medical attention and support. By reducing the stigma surrounding addiction, we can improve access to treatment and ultimately save lives.
The Importance of Proper Disposal of Unused Prescription Medications
Proper disposal of unused prescription medications is crucial in preventing the misuse and abuse of these drugs. Many people who become addicted to opioids start by taking prescription medication that was not prescribed to them.
One way to properly dispose of unused prescription medications is through drug take-back programs. These programs allow individuals to safely and easily discard their unused medication at designated locations such as pharmacies or police stations. Drug take-back programs are an effective way to prevent unused medication from falling into the wrong hands.
Another option for proper disposal is through at-home methods such as mixing medications with coffee grounds or kitty litter and disposing of them in the trash. However, it's important to note that flushing medication down the toilet or sink should be avoided as it can harm the environment.
By properly disposing of unused prescription medications, we can help prevent addiction and overdose deaths while also protecting our environment. It's important for healthcare providers to educate their patients on safe medication use and disposal methods to ensure that prescription drugs are used only as intended.
Not about Willpower
Though treatment that addresses compulsive behaviors sounds like it is just teaching you to stand strong in the face of temptation, willpower does not come into play. Rather, the idea is that if the underlying conditions (e.g., trauma, stress, anxiety, depression, etc.) are treated, then the urge to engage in compulsive behaviors will decrease naturally. Additionally, by learning new coping mechanisms, it is possible to find other ways to manage uncomfortable emotions and thereby make those the behaviors of choice – healthy, positive behaviors that improve quality of life rather than cause it to deteriorate.
Comprehensive Care and Long-term Support
Learning how to mitigate and manage compulsive behaviors is a key part of recovery from addiction, but it is not something that can be absorbed overnight. These new skills are first learned during treatment but they become part of your new life in recovery over time with practice. Life will throw you plenty of opportunities to put your new skills to work. With the right support system in place and an ongoing connection with the new life principles you learned in treatment, it will become easier to make healthy choices when faced with stress rather than engaging in addictive behaviors.
What do you need to gain control in your life?
The opioid epidemic is a serious issue that affects many people across the United States. Louisiana's high rate of painkiller prescriptions is alarming, but the state is taking steps to address the problem. Prescription Monitoring Programs and Good Samaritan Laws are just a few of the ways that Louisiana is working to prevent prescription drug abuse. It's important for individuals to be aware of the risks associated with painkiller prescriptions and to use them only as prescribed by a healthcare provider.
- Centers for Disease Control and Prevention. (2019). Opioid Overdose. https://www.cdc.gov/drugoverdose/data/statedeaths.html
- Centers for Disease Control and Prevention. (2017). Understanding the Epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html
- Louisiana Department of Health. Prescription Monitoring Program (PMP). https://ldh.la.gov/index.cfm/subhome/57
- Louisiana State Legislature. Good Samaritan Law. http://www.legis.la.gov/legis/ViewDocument.aspx?d=962106