Opioids: Are They Worth It?

Introduction

The epidemic of opioid use and misuse began in the 1990s and has resulted in over 200,000 deaths. Every year, millions of Americans use opioids to manage pain. These substances have been around for hundreds of years.  Some prescription opioids are made from the plant directly, and the ones that are not, are made by scientists in labs using the same chemical construction. Opioids are often used as medicines because they hold elements that relax the body and can manage pain.

In most cases prescription opioids are used to treat reasonable to severe pain, though some opioids can be used to treat coughing and diarrhea. Opioids can also make people feel comfortable and high, which is why they are sometimes used for non-medical purposes. This can be dangerous because opioids can be highly addictive, and overdoses and death are common.

Around 47,000 Americans die from prescription opioid overdoses each year. Who is to blame? Are the doctors at fault for over prescribing it? Is the human body growing tolerance and leading to addiction? According to R.

A. Rudd , “The United States is experiencing an epidemic of drug overdose (poisoning) deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin,)” which suggests that opioids are a topic of concern today. In this essay, I will be exploring the effects of opioids to the human body, what causes addiction, a doctor perspective, and prescription of opioids through a scientific lens, and exploring whether opioids are the best solution.

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The Human Body and Brain

Opioids bind to opiate receptors in the brain, spinal cord, and other locations in the body. By binding to these receptors, they block the perception of pain. Opiates can block pain and cause feelings of comfort, but they can also cause side effects such as nausea, confusion, and drowsiness. The Mayo Clinic staff claims “Opioids propose a danger of addiction, overuse, and overdose. Some people can even become addicted when taking them exactly as prescribed, but the hazards can be increased by not taking them as directed or by combining them with other ingredients, like other drugs.” Furthermore, the pressure to use opioids shapes over time to extend beyond a simple ambition for pleasure.

The increased compulsion is related to tolerance and dependence. Conferring to Thomas R. Kosten, M.D. and Tony P. George, M.D., “Opioid tolerance occurs because the brain cells that have opioid receptors on them progressively become less responsive to the opioid stimulation. For instance, more opioid is required to stimulate the VTA brain cells of the mesolimbic reward system to release the same amount of DA in the NAc. Consequently, more opioid is needed to produce pleasure equivalent to that provided in previous drug-taking instances.”

Addiction to Opioids

According to the Mayo Clinic, “Doctors define drug addiction as an irresistible craving for a drug, out-of-control and compulsive use of the drug, and continued use of the drug despite repeated, harmful consequences. Opioids are highly addictive, in large part because they activate powerful reward centers in your brain,” which evidences that drug addiction can be very dangerous.  One purpose opioid addiction is so ordinary is that people who progress tolerance might feel inclined to increase their doses, so they can keep feeling good and this is very dangerous because it can lead to overdose. Opioids are most addictive when taking them using approaches that are changed from what was prescribed, like crushing a pill so that it can be snorted or injected. This serious exercise is even more unsafe if the pill is a long- or extended-acting formulation. Quickly delivering all the medicine to the body can cause an unintentional overdose. Taking more than the prescribed dose of opioid medication, or more often than prescribed, also increases your risk of addiction. Other factors that are to be considered when talking about opioid addiction are stressful circumstances, history of severe depression or anxiety, or family history of substance abuse.

The Doctor Standpoint

In earlier times, doctors spoke out contrary to the use of pain remedies. They claimed that pain was a good thing, a sign of physical strength and important to the healing process. In current time, treating pain is every doctor’s authorized obligation. According to Anna Lembke M.D, “In 2001, the Medical Board of California passed a law requiring all California-licensed physicians to take a full-day course on “pain management.” This means that doctors were highly educated and knew when the appropriate times to prescribe opioids were. Lembke also states “some people believe that pain that’s left untreated can cause a psychic scar, post-traumatic stress, and doctors who deny opioids to patients who report feeling pain may be seen not only as withholding relief, but as inflicting further harm through psychological trauma.” Most overdose deaths are due to prescription opioids which implies that opioids should be less accessible and more regulated. The reason doctors re so hesitant/unsure about opioids is because not every patient has the best morals at heart. It’s hard for a doctor to choose when he/she can or can’t prescribe these drugs to patients

Prescription

According to the CDC, “Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient. If opioids are used, they should be combined with nonpharmacologic therapy and nonopioid pharmacologic therapy, as appropriate,” which shows that opioids should only be prescribed when there is no other alternative. If it’s necessary to prescribe these drugs, the physician should be highly regulating them. Physicians are required to ask patients to sign an opioid therapy agreement form before starting a long-term course of opioid medication. Physicians are also advised to prescribe the lowest effective dose, for the shortest period needed, when treating acute pain and avoid or delay prescribing opioids for chronic pain. There have been multiple studies to prove that doctors who prescribe opioids may not be prescribing the right amounts or mistreating the patient and giving them something they don’t need. According to Carlos A Pino, MD Melissa Covington, MD, “In a survey of approximately 210 patients who underwent urologic surgery, 67 percent of patients had surplus medication after discontinuing opioid use, and 91 percent of them saved the pills,” and this serves to prove that these drugs should be controlled and taken more seriously before prescribes.

The Outcome/Recommendation

[bookmark: _Hlk534191537] Opioids are used to treat chronic ache and relieve pain temporarily, and they are the only solution that has the relieving effects known to humans for now. Coming from a scientific lens, opioids manage discomfort and they are narcotics that act on receptors to produce morphine-like effects. Medically, they are primarily used for pain relief, including anesthesia and there is not a better option or substitute that mimics these effects. Although if prescribed and taken properly, they will fulfill their purpose, it still has horrible side-effects and can lead to addiction and overdose. Opioids can cause long-term effects to the human body and brain, but it is apparent the chemicals used to make them are relatively safe for use and improve conditions. Unless scientists find a substitute for opioids that isn’t addictive, prescribing opioids will be the only option, while still taking into consideration that more regulations need to be put in place before prescribing opioids.