Death by Overdose

Drug overdoses now kill more people than gun homicides and car crashes combined. In 2015, more than 52,000 people died of drug overdoses. That’s more drug overdose deaths than any other period in US history — even more than past heroin epidemics, the crack epidemic, or the recent meth epidemic. In Tarrant County alone, almost 200 people died from drug overdoses in 2015. Unfortunately, preliminary data from 2016 suggests things are not getting any better.

The epidemic has by and large been caused by the rise in opioid overdose deaths. Americans consume more opioids than any other country in the world. There is now a medication for persons who have opioid induced constipation. In some states, doctors have filled out more painkiller prescriptions than there are people. Texas is one of those states. As a personal aside, my husband underwent quadruple bypass heart surgery last year and was given multiple prescriptions for opioid painkillers, none of which he used after discharge from the cardiac ICU. Ibuprofen and acetaminophen proved to be much more effective in addressing the pain from the surgery.

Doctors are filling out a record number of prescriptions for opioids to treat patients’ chronic pain conditions and as a result opioid use disorder is rising. Individuals now addicted to painkillers move over to heroin as they are denied their prescriptions or the prescriptions they are able to obtain do not satisfy the physical or psychological craving they experience. Most recently, people have begun using fentanyl, an opioid that’s even more potent and cheaper than heroin. The result is a deadly epidemic that shows no signs of slowing down.

I feel one of the most alarming facts that has surfaced in this epidemic is that despite drug companies’ marketing claims, opioid painkillers are not an effective treatment for long term, chronic pain. While drug companies have made a lot of money marketing opioids as a solution to chronic pain, there is not any good scientific evidence that opioid painkillers reduce chronic pain as persons grow tolerant of opioids’ effects. There is a great deal of evidence however, that prolonged opioid use can result in a higher risk of addiction, overdose, and death.

What happens as patients try to stop taking opioids on their own is they will experience a sudden surge of pain, headaches, nausea, joint pain, restlessness, etc. They interpret the symptoms they feel as the original acute pain returning now that the opioids are gone. In reality, the opioids stopped working on the original pain a long time ago due to tolerance. What they are actually experiencing are the symptoms of withdrawal from the medication. Only by medically supervised withdrawal from opioids can persons truly combat the addiction, deal with new withdrawal-induced symptoms and learn more effective ways of coping with and reducing the original source of pain.

The following white paper may be useful in identifying issues for women and Opioid Use Disorder: White Paper: Opioid Use, Misuse, and Overdose in Women.

Additionally, Sam Quinones book Dreamland:The True Tale of America’s Opiate Epidemic is a marvelous explanation of the opioid epidemic in America.