The opioid epidemic in the United States has been in the making for over 20 years. Overdoses attributed to opioid use are nearing 50,000 deaths per year. There is limited evidence suggesting usage rates may have leveled off. But, solutions are still necessary to help the 2 million people who suffer from substance use disorders linked to prescription opioids.
Armed with $40 million in funding, the National Institutes of Health (NIH) is prepared to just that. Launching the Helping to End Addiction Long-term initiative, or HEAL, the NIH is focused on speeding up the discoveries of solutions aimed at slowing and reversing the opioid health crisis.
One such discovery has proven to be somewhat promising. By learning about fatal opioid overdoses, there was a marked change in prescribing behaviors by physicians. The simple experiment may be the first of many ways to prevent opioid abuse.
Courtesy Communications of Opioid Overdose
The experiment was modest, if not out of the ordinary. In San Diego County, 170 individuals who died from a fatal prescription overdose were identified. Next, researchers connected 861 clinicians who wrote at least one opioid prescription to a deceased individual.
Over the course of twelve months, letters were sent to each of the clinicians. Each letter advised the clinicians that one of their patients had an opioid-related overdose. The prescribed opioid was mentioned to be either the primary cause or a contributing cause of the person’s death.
The letters had been described as a “courtesy communication.” Each letter revealed the patient’s name, date of birth, and their date of death. The NIH’s goal in sending the letters was to determine if learning about their patient’s death would curb the number of opioid prescriptions moving forward.
One Way to Prevent Opioid Abuse
University of Southern California researchers, having worked closely with the county’s chief medical examiner, found some promising results. A month after the letters were sent, the team compared prescription patterns against a control group. The study continued for three months until enough data was gathered to produce reliable conclusions.
As a group, it was learned nearly 10% fewer prescriptions were written after the clinicians received a letter. It can only be suggested fewer prescriptions translate into fewer opioid-related overdoses as the data set it too small in comparison to the behemoth that is the opioid crisis.
However, what may be more promising is the same group was 7% less likely to put new patients on an opioid medication. The letters indeed had an effect on the clinicians’’ prescription decisions and expanding the program may indeed be one way to prevent opioid abuse.
Exactly why the clinicians changed their prescribing practices has yet to be fully understood. One hypothesis is the use of a mental shortcut, also known as the availability heuristic, whereby our mind looks to immediate examples when making a decision. Whatever the reason, the initial experiment proves to promising, cost-effective way to begin making strides toward tackling the opioid epidemic.
Although California’s opioid-related overdose rates are lower than the national average, they cannot be ignored. In 2016, the state saw 2,012 opioid related-overdoses. This equates to nearly five deaths per every 100,000 people. Almost the same rate as homicide mortality in California.
California opioid abuse, while bleak, has not risen at the same pace as other states. At the turn of the century, California had some of the worst statistics surrounding drug use and drug-related deaths. Over a 15 year period between 1999 and 2015, general drug-related deaths increased 30% each year according to the Centers for Disease Control.
However, the rates in some states, particularly those east of the Mississippi, saw drug-related deaths climb 975%. Over time, the rest of the United States simply passed California. Therefore, even though states such as West Virginia are making national headlines regarding their opioid epidemic, it is important to keep a pulse on California’s trends.
For now, opioid prescriptions are declining. In 2013, there were 54.9 opioid prescriptions written for every 100 people. With a state the size of California, this means approximately 21 million opioid prescriptions. By 2015, the state saw a 12.8% decline in opioid prescriptions. The result was 47.9 prescriptions per 100 people, or 18.7 million total opioid prescriptions.
One of the best ways to affect the opioid crisis to prevent opioid abuse in the first place. Unfortunately, this is much easier said than done as money may be fueling the opioid epidemic.
The sale of OxyContin in 2017 produced $1.74 billion in sales for maker Purdue Pharmaceuticals. Evidence is mounting that pharmaceutical companies have been deceptive in the marking of prescription opioids. And, in some cases, committing fraud when it comes to marketing practices.
Hundreds of lawsuits are filed annually against opioid makers and their distribution partners. The States, under the financial strain of fighting the opioid crisis and the increasing death toll, are joining together to seek retribution from opioid companies to help fight the crisis.
With pressure mounting from both the state and Federal governments, the expected changes to pharmaceutical marketing practices hope to turn the tide against opioid abuse. As many of the eastern states, such as New York and Connecticut, take on the pharmaceutical companies head-on, California opioid abuse will hopefully begin to see the declining trend continue.
Treatment Options for Opioid Abuse
Opioid addiction is a chronic condition that requires the assistance of skilled professionals to help those afflicted. The use of opioids changes the brain in very real ways. These changes make it extremely difficult to break the addiction with willpower alone.
Through medications and counseling, individuals addicted to opioids can find a path that leads them free of the drug’s grip. Medications such as methadone and buprenorphine can reduce the symptoms of withdrawal. Introducing naltrexone can become a part of a treatment plan after detox to stop the body’s ability to get high from using.
While medications provide a short-term solution to opioid addiction, professional counseling centers are crucial for long-term success. Rehabilitation centers are able to treat the whole body in addition to the mind. The result is a transformation of one’s entire self toward a clean and healthy lifestyle.
If you or someone you know is suffering from opioid addiction, please contact Ocean Hills Recovery to find out how we can help.
About the author:
Nicole earned her doctoral degree in Psychology with an emphasis on marriage and family therapy at California School of Professional Psychology. Her doctoral thesis was a grounded theory study exploring the role of alienation and connectedness in the life course of addiction. She specializes in treating addiction and trauma. She is certified in DBT and EMDR, two of the most highly regarded evidence-based methods in psychotherapy. Dr. Doss is a strong LGBT advocate and provides open and affirming support to her LGBT clients.
Dr. Doss’s earlier education included graduating cum laude from the University of California, Irvine in June of 2007 with a Bachelor’s degree in Psychology. While there, she received honors recognition by Psi Chi and Golden Key honor societies.
Nicole has been working with alcoholics and addicts in our California drug and alcohol rehab center as an advisor and counselor for many years. She is passionate about providing quality counseling and care to her clients. Her main focus is on integrating the 12 Step and disease models of addiction with experiential therapeutic theory. She is married to Greg; they have two adorable sons together and an energetic yellow Labrador Retriever.