● Pseudoaneurysms : False aneurysm. It is an abnormal bulge on the outside of an artery vessel wall that has not ruptured. Increased blood pressure or any disturbance may cause a rupture of the vessel (aneurysm). ● Tolerance : Develops because of the repeated and continued exposure of a drug over time. The body Introduction Opioid use has grown substantially over the past decade. Over the years, it has been common practice by physicians to prescribe pain relievers to individuals who, for a variety of reasons, suffer acute or chronic pain. These medications suppress the nerves to the brain and spinal cord, thus causing temporary relief. However, when patients deviate from the prescribed opioid dosage and abuse the prescription, the consequences can be severe, including death. Recognizing the need for intervention, state and
adapts to the frequent presence of the opioid, which decreases its effectiveness. Because of the reduced reaction to the drug, one must take a larger dose to achieve the same effect.
local government offices have enacted laws to move from mass incarceration to providing needed treatment. Drugs to combat overdoses are now being given to family and friends of the opioid dependent in case of an unexpected overdose. This epidemic has become such an issue that by the time you have completed this course, five people will have died from an opioid overdose. What is more astonishing is that half of these deaths are not from illicit drugs, but from opioids prescribed by physicians.
OPIOID EPIDEMIC
overdosing on opioids (National Institute on Drug Abuse, 2019). In the United States, a person is more likely to die of an opioid overdose than an automobile accident. But it does not stop at car crashes. Opioid overdoses are the leading cause of accidental deaths. In 2017, the U.S. Department of Health and Human Services declared it a public health emergency. According to the Illinois Department of Health, opioid-related deaths increased 82% between 2013 and 2016 in Illinois, and this number is continually rising (Conley- Keck, 2019). When snorting the crushed pills, a lot of the product is lost in the mucous membranes of the nares, and there is not an immediate high. The dependent user has found by crushing the pills or opening the capsule into water and letting it dissolve, the user is able to inject directly into the bloodstream. The user gets high instantly. It is also less expensive because the user is not using as much of the opioid. By snorting, one feels the affect in 15 minutes versus injecting where the wait is only 8 seconds. Another issue is when the patient becomes addicted and takes someone else’s prescriptions, either by going through others’ medicine cabinets or by stealing medications from family or friends. As doctors are becoming more aware of the issue, they often are more reluctant to prescribe the opioid medication. The patient then switches primary care physician and tries to establish new prescriptions. This is termed “doctor shopping.” Lastly, there is the method to establish connections needed to receive the drugs on the streets. This can be as dangerous as the drug itself by putting oneself in precarious situations and meeting individuals at all hours of the night to satisfy the cravings. As one can see, a gradual set of circumstances can lead to more dangerous behaviors. Over time, users develop a tolerance, which causes them to use a higher dose of the drug to retain the same effects as when they first began using. The issue has become so alarming that the American Physical Therapy Association is raising awareness about the dangers of prescription opioids and encouraging consumers to choose safer alternatives like physical therapy for most chronic pain management. The American Dental Association wants to drastically limit prescribing opioid medications. The American Medical Board has created its own Opioid Task Force (American Medical Association, 2018). This task force has produced a microsite specifically for physicians that has an abundant amount of educational materials and resources
An epidemic is an outbreak that affects a large percentage of individuals at the same time in any given area. It can be a disease, obesity, contaminated foods, or, in this case, opioids. The trajectory of the crisis of opioid overdose deaths has turned into just that—a national epidemic. But the issue is quickly turning from an epidemic into a pandemic, which is a worldwide issue. In Illinois alone, 11,000 individuals have died from opioids since 2008 (Conley-Keck, 2019). Since 2002, opioid-related deaths have grown nearly 300%. On average, more than 130 Americans die each day after Opioids Opioids are in a class of drugs that comes in many forms. Prescription opioids are often prescribed to treat and manage pain. They are a class of drugs found in either the opium poppy plant or made by scientists in labs (National Institute on Drug Abuse, 2018). Common prescription opioid drugs are hydrocodone (Vicodin, Norco), oxycodone (OxyContin, Percocet, Opana), morphine (Kadian, Avinza), and codeine (Tylenol with Codeine No. 3). This also includes synthetic drugs like fentanyl (Duragesic) and methadone (Diskets Dispersible), and illegal drugs such as heroin. If any of these drugs is taken in abundance, respiratory depression can occur—this is the overdose. One of the worst opioids is carfentanil, an elephant and rhinoceros tranquilizer, which is 100 times more potent than fentanyl and 10,000 times more potent than morphine. Just 20 micrograms of carfentanil, which would be the size of a grain of salt, is fatal. Physicians and oral surgeons often prescribe opioids for pain relief. Circumstances for these pain management medications include breaking a bone, a sports injury, or having a root canal. In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers, and health care providers began to prescribe them at greater rates (National Institute on Drug Abuse, 2019). But this is not the issue. The problem lies with the individual who uses more than what is prescribed and abuses the medication, deviates the way it is prescribed, or changes the dosage other than instructed (National Institute on Drug Abuse, 2018). Many individuals start with pills, either swallowing them or crushing them into a powder form and inhaling the contents (Pearl, 2018). Over time, they find more effective and efficient ways to use—usually the advice coming from their friends or other users. This is when they move to intravenous injections because it is an immediate high and is less expensive.
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