On average, 130 Americans die every day from an opioid overdose. This massive health epidemic has received national attention due to how serious and deadly the use of opioids is.
What are opioids and how do they work?
Opioids, sometimes called narcotics, are medications that are prescribed to treat persistent or severe pain and are used mainly by patients recovering from surgery or serious injuries and cancer patients with severe pain. Opioids attach to opioid receptors on nerve cells in different parts of the body, like the brain or spinal cord. In doing so, opioids block out pain messages traveling to the brain. There are many different types of prescribed opioids, including codeine, morphine or heroin. Opioids can be taken as pills, lollipops, injections or patches.
What’s so bad about opioids, anyway?
Opioids have many side effects, such as sleepiness and nausea. There are more serious side effects, however, such as slowed heart rate, loss of consciousness, liver damage and brain damage. Withdrawal symptoms can also occur, in the form of jittery nerves or insomnia. But, the worst problem of them all is developing an addiction — a huge mental health issue. Opioids trigger the release of endorphins, the neurotransmitter that makes you happy. When an opioid dose wears off, you may want those feelings back and take more opioids. This nasty cycle leads to addiction. Addiction to opioid prescriptions can often lead to the use of heroin, an illegal opioid. In fact, around 80% of heroin users admitted to misusing prescription opioids before they turned to heroin.
How did the opioid crisis begin?
In 1991, pharmaceutical companies assured the medical community that opioid pain relievers were not addictive; as a result, more doctors began to prescribe opioids. Pharmaceutical companies had promoted the use of opioids in patients with non-cancer related pain (even though there had not been a large amount of research to support this conclusion) and by 1999, 86% of patients using opioids were using them for this reason.
In 2010 there were a huge number of deaths from heroin abuse. When the medical community started to realize the dangers of opioids, prescription opioids were made harder to get. Because of this, people started to use heroin— which was cheap, illegal and readily available.
In 2013, there was an increase in deaths related to synthetic opioids like fentanyl. Over 20,000 people died from using fentanyl and other related drugs in 2016. Opioid overdoses increased 70% from July 2016 to September 2017 in the Midwest alone. It’s a national emergency.
I spoke with Dr. Farha Abassi, an assistant professor in the Psychiatry Department here at Michigan State University. Dr. Abassi explained to me that opioids have no role in the long term treatment of nonmalignant pain: “When you take opioids, your reward system gets activated. You feel high and euphoric. But, your pain worsens in withdrawal. In the past, people were usually dying because of heroin and meth use. But now, it’s fentanyl use, which is a narcotic.”
Why Should You Care About the Opioid Crisis?
A recent survey from March 2018 revealed that 25% of college students meet the standard for substance abuse and the rate of drug addiction in college students is higher than that in the general public — the majority of students abusing Adderall for nonmedical purposes were college-age students.
I asked Dr. Abassi how she advises college students who are struggling with addiction, not only to opioids but in general. “Know there shouldn’t be any judgment.Addiction is a disease. You’re not a bad person or that something is wrong with you.” She explained to me that students who misuse drugs are often trying to self treat some underlying cause, such as a mental health issue like depression or anxiety. If you’re in pain, you’re just going to make your pain worse by using the drug you’re addicted to. “It’s easier to get drugs than it is to get into rehab and get clean,” Dr. Abassi stated. “If it’s easier for you to access drugs, that’s when you need help. It’s harder for you to accept mental health treatment.” She likens this example to addiction: “If you had cancer, what would you do? You’re going to go to chemotherapy. You’re not going to smoke or drink.”
Dr. Abassi advises students to reach out and get the help that they need. Here at Michigan State, we have an amazing resource — Olin Health Center. Dr. Abassi, who is also a staff psychiatrist at Olin, speaks very highly of it as well. “They work so hard to deliver the best care possible to our students. There are solutions to mental health issues.”