There is currently an opioid epidemic in the USA, where patients are taking improper amounts of opioids, leading to dependence on the drug and addiction. This problem is perpetuated by a poor understanding of how opioid drugs work and a new review aims to increase our understanding of how opioid drugs work to prevent future opioid abuse and misuse.
Opioids are a class of drugs that are given to patients in many cases to manage various types of pain. However, many are concerned that they are being over-prescribed and patients are taking improper amounts of the drug. There is currently a huge problem with opioids in the USA, in that they are being over-prescribed and over-used with many patients. In fact, the amount of opioid overdose deaths doubled from 2000 to 2014. This problem has widespread impacts in the American economy and both the mental and physical well-being of their citizens. We have reached this point because there is extreme pain associated with many diseases, and because opioids are widely prescribed. A new review, published in Pain and Therapy, looks at the potential overuse and abuse of opioid usage. The authors will summarize the current literature and information known about how opioids work in hopes of preventing future opioid abuse and misuse.
Pain is detected in some part of our body, and the signal travels through nerves, which connect to the spinal cord. The signal travels up to our brain, where it is interpreted to be pain. The brain then sends a signal through other nerves back down to our body that can change the incoming signal. Opioid drugs can bind to receptors on the nerves, the spinal cord, or the brain, to stop these pain signals. There are also side effects that come with opioid usage, such as nausea, vomiting, skin lesions, and constipation. Newer pain medication aims to have both opioid and non-opioid mechanisms to reduce these side effects. The mechanisms by which these drugs work is understood, however, it was believed for a long time that all opioids were pretty similar, due to them belonging to one drug class. However, more current research has shown that there are in fact larger differences between each drug than previously thought. The usage of certain opioids is known to be less abused than others, even though they have the same effect in reducing pain. Therefore, it is important for healthcare providers to consider the addictiveness of the drugs they are prescribing.
Another factor that affects the effectiveness of opioid drugs is dependent on the patient’s genetics. Therefore, it can be useful to switch between multiple opioid drugs to treat pain. There is also a lot of conflicting opinions on whether opioids should be prescribed long-term for chronic pain and when its use is warranted for how severe the pain is. Opioid tolerance can occur very quickly, which leads to the drug being less effective. This can also lead patients to request for higher doses of opioids, resulting in dependency. Opioid usage is also often associated with a pleasant feeling, which can easily make patients addicted to the drug. Furthermore, studies have shown that the likelihood for someone to abuse opioid use is influenced by a few known risk factors such as: younger age, male gender, mental health disorders. In some cases, abuse of the drug eventually turns into addiction.
It is important for both healthcare providers and patients to be well informed on how these drugs can impact the patients’ lives. Importantly, healthcare providers can choose certain opioid formulations that can lead to a lower likelihood of abuse or misuse. Additionally, more efforts can be made to evaluate the risk of a patient abusing opioids, and to take extra precautions for higher risk patients. On the other hand, patients can ask their healthcare providers for more information on the drugs they are being prescribed and even do their own research using online resources to learn more about the side effects and risks of using opioid drugs. With a greater understanding within both parties of how opioids work and what they can do, more measures can be taken to prevent the growing about of abuse of misuse of opioid drugs.
Written By: Branson Chen, BHSc