Running head: OPIOID EPIDEMIC 1

Opioid Epidemic

Nicole DiMaio

Pace University
OPIOID EPIDEMIC 2

Opioid Epidemic

At least 130 people die daily in the United States because of an opioid overdose. It is

undeniable that opioid misuse is leading to increasing rates of addiction among the populations.

Some of the commonly abused drugs include prescription pain relievers, fentanyl, and heroin.

The opioid epidemic is a national crisis, which continues to affect the nation’s public health,

economic, and social welfare. According to the Centers for Disease Control and Prevention

(CDC), the total economic burden associated with the misuse of opioid drugs is about $78.5

billion annually (National Institute of Drug Abuse, 2019). This entails the cost of addiction

treatment, healthcare, criminal justice service, and lost productivity.

The health problems related to opioid use did not start yesterday, but it began as long as

the 1990s. In the 1990s, the pharmaceutical companies assured the society that there is no

problem with a high rate of production of pain relievers because people will not develop an

addiction to such drugs (National Institute of Drug Abuse, 2019). The healthcare providers,

therefore, began to prescribe those drugs at a very high rate. Unfortunately, the opioid overuse

and misuse became one of the various effects that the pain relievers caused to society. The

overdose rates began to rise.

In the year 2017, the forms of opioid overdose including heroin, opioid overdose, and

illicitly made fentanyl resulted in the loss of over 47,000 Americans (National Institute of Drug

Abuse, 2019). In the same year, about 1.7 million people of the United States developed

prescription opioid-related disorders (National Institute of Drug Abuse, 2019). Over 652,000

people suffered from disorders relating to heroin use (National Institute of Drug Abuse, 2019). It

is evident that opioid use is an epidemic in the country due to the health challenges that it causes
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to several people in the society. Families are now suffering from the high cost of treatment and

the fact that most of the young people that lack financial independence and they depend on their

families for healthcare are increasing the burden because of opioid use.

Problem Statement

The government seems not to be taking any action to prevent the opioid epidemic from

claiming more lives in the future. It is evident that several pharmaceutical companies are now

controlling the government because they target individual leaders whose contributions to

decision-making in the countries are key. As a result, the production of opioids and other pain

relievers is still increasing as pharmaceutical companies are aiming at making exorbitant profits.

As a result, it is evident that the government is not putting enough efforts to control the

production rate and the prescription rate for pain relievers. The government is also limiting the

efforts of the alternative concerned agencies like the Drug Enforcement Agency (DEA). It is,

therefore, evident that the main challenge that society is facing today is the threat of uncontrolled

actions of pharmaceutical companies.

Importance of Opioid Epidemic

The opioid epidemic is an issue of concern in the United States because it is claiming

several lives every year. It is a national emergency. Relative to the white house commission

report compiled by the National Public Radio (NPR), it is evident that the opioid epidemic has

reached the level of becoming a national crisis (Nova Recovery Center, 2018). It is necessary for

president Trump to pronounce the opioid crisis as a national emergency. A national emergency is

a public health emergency that is killing people at a very high rate. It is apparent that opioid

overdose is now causing a high mortality rate among prescription opioid users (Nova Recovery
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Center, 2018). Opioid drugs target the brain, and they can regulate breathing. When an individual

consumes an excessive quantity of opioids with sedatives or alcohol, he or she can experience

symptoms like pinpoint pupils, respiratory depression, and unconsciousness (Nova Recovery

Center, 2018). These symptoms can easily cause death because they cause the opioid overdose

triad.

The opioid epidemic is important for discussion because several young people are at risk.

Individuals at risk include people with high tolerance level because of incarceration, undergoing

addiction treatment, or recent detoxification (Nova Recovery Center, 2018). In addition, the

people that consume excessive amounts of prescription opioids, undergo opioid injection, and

individuals suffering from medical conditions like obesity, diabetes, or cancer are also at risk

(Nova Recovery Center, 2018). Finally, individuals that are using opioids and sedatives or

alcohol simultaneously are at risk of opioid overdose, complications, and dangerous drug

interactions (Nova Recovery Center, 2018). Ideally, although not all opioids are lethal, it is

undeniable that opioid overdose has become an epidemic due to the high rate of prescription and

the high rate of production of these pain relievers across the nation. The United States

government is reluctant to regulate the production rate, and the extent of damage caused to the

populations at risk is increasing each day. As a result, if this issue goes undiscussed and

unexposed for a long time, people will not access the necessary information concerning the risk

that they may face shortly.

Stakeholders and Their Perceptions/Goals

The principal stakeholders in this issue include the government, pharmaceutical

companies, and the media. These stakeholders have the power and the mandate to change the
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situation by ensuring that society understands that the opioid is an epidemic in the country. To

begin with, the government should regulate the work of pharmaceutical companies to regulate

the rate of production of the pain reliever. Ideally, having realized that a significant population is

losing lives every year, the government should act faster to prevent more loss of lives due to an

overdose of prescription opioids (National Institute of Drug Abuse, 2019). In healthcare settings,

the government should monitor the rate of prescription of opioids by healthcare providers. It is

apparent that the rate of prescription of these opioids aimed at relieving pain is high, and

therefore the rate of misuse and overdose is significantly high. The government should watch

and develop regulation and enforce them to ensure that healthcare providers can only prescribe

pain medication whenever necessary. Unfortunately, the government is not implementing these

mandates because it has a different perception of the opioid epidemic.

Instead of regulating the pharmaceutical companies to reduce the production rate for

opioids, the government is increasing the availability of treatment and recovery services for

opioid epidemic victims (National Institute of Drug Abuse, 2019). The government is promoting

the use of overdose-reversing drugs. Thirdly, the government is supporting research on addiction

and pain (National Institute of Drug Abuse, 2019). The United States administration is advancing

better practices in pain management and strengthening the knowledge of the public about the

epidemic through public health surveillance.

It is evident that most of these actions implemented by the government show that the

government has accepted the problem and it is only focusing on treating its consequences,

instead of preventing the problem. It is as if the government approved the high rate of

production of pain medication. This is because it is possible to reverse the adverse effects that

pain medication can cause when people overuse drugs. However, it is unfortunate that people
OPIOID EPIDEMIC 6

cannot easily access drugs that can reverse the addiction. Pharmaceutical companies, on the other

hand, are only focusing on making a profit by increasing the supply of pain medication. This is

unethical because as stakeholders in the health care system, they should develop a concern about

the increasing rate of an opioid overdose. They should understand that the overproduction of

pain education would only increase the illicit utilization of these drugs. Instead, the

pharmaceutical companies maintained that people would not develop an addiction to pain

medication. Ideally, there is no comment made by any pharmaceutical company yet concerning

the need to develop effective measures to reduce the production and prescription rate for opioids.

The media should play a crucial role in exposing the epidemic for several people to

understand the looming threat. It is evident that the media are a whistleblower and they should

expose facts about the opioid epidemic for all stakeholders to understand and take the necessary

actions to prevent further challenges relating to the opioid epidemic. Through the information

that the media exposes to the public, the public can organize to prompt the government to play its

part effectively by regulating pharmaceutical companies, which seem to have power over the

government today. The media is working effectively to ensure that it reports facts. The National

Public Radio already proved that the opioid epidemic is a national emergency. It took action to

publish an article seeking the attention of the president and the White House (Allen, 2017).

According to National Public Radio, President Donald Trump should declare the opioid

epidemic a national emergency (Allen, 2017). In particular, this shows that the media has facts

about the threat, and they are executing their mandate effectively by providing facts about the

epidemic.

Support Strategy
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The strategy is to reduce the production rate of opioids and other pain medication that can

increase the rate of addiction and overuse. Alternatively, pharmaceutical companies should

develop new safe and effective non-addictive products or strategies to facilitate chronic pain

management (Rudd, 2016). Secondly, pharmaceutical companies should also invent new

medications and the technologies that enable treatment to opioid use disorders. Thirdly,

pharmaceutical companies should enhance overdose prevention and reversal processes to save

lives and back recovery efforts among opioid addicts. Something is missing in this strategy, the

government oversight. It is unfortunate that while these are some of the proposed strategies

through which pharmaceutical companies can help the society to control the opioid epidemic,

there is no evidence of any government intervention to ensure that the strategies are successful. It

is unclear the extent to which these companies moved ahead to implement this strategy. The

government did not a follow-up to see if the pharmaceutical companies implemented these

alternative pain management strategies.

Collaboration between the government and the pharmaceutical companies is essential

because the government has a role of checking the progress of the pharmaceutical companies in

implementing alternative pain management strategies (Rudd, 2016). Since the opioid epidemic is

currently at a severe rest in the country, the government and the pharmaceutical companies

should be swift in implementing the new strategies. In particular, this can help in alleviating the

crisis and help many people that are at risk of developing opioid-related diseases to remain safe.

The Director of the National Rx Drug Abuse and Heroin Summit, Francis S. Collins announced

the launch of the “Helping to End Addiction Long-term (HEAL)” initiative in April 2018. It is

currently unclear how far the HEAL initiative reached in alleviating the opioid epidemic in the

country. Sometimes, the government can express its willingness and effort to change the status
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quo relative to the increase of the risk of opioid-related but its actions remain unclear. Since

April 2018, there is no significant change noted in the reduction of opioid overdose cases to

prove the effectiveness of the HEAL program.

Data Available

Approximately 21% to 29% of patients prescribed opioids for the treatment of chronic

pain end up misusing the drugs (National Institute of Drug Abuse, 2019). In addition, between

8% and 12% of the patients that misuse prescription opioid drugs end up developing opioid-

related disorders (National Institute of Drug Abuse, 2019). While about 4% to 6% of the patients

that misuse opioids transition to heroin, it is evident that more than 80% of the people addicted to

heroin initially misused opioid drugs (National Institute of Drug Abuse, 2019). The current data

clarifies the relationship between opioid overdose and misuse with the increased rate of addiction

to heroin among opioid users. It is evident that healthcare providers rarely asses the patients

critically to ensure that they only prescribe enough opioid to last for a few days. As a result, the

patients can have enough opioids to misuse even when the pain ends. In July 2016, prescription

opioid overdose increased by about 30% including in September 2017 in about 52 areas in 45

states across the country (National Institute of Drug Abuse, 2019).

In the Midwestern region, the rate of opioid increase reached over 70% between July

2016 and September 2017 (National Institute of Drug Abuse, 2019). In large cities, it is evident

that the rate of opioid overdose increase by approximately 54% in only 16 states (National

Institute of Drug Abuse, 2019). It is evident that the issue of opioid overdose and addiction has

become a national crisis. It is unclear the level of success of any efforts that the government

implemented to address the opioid epidemic over the past three years. Concerning the severity of
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this threat, the data available include the fact that opiate toxicity entails the triad of respiratory

depression, miosis, and the central nervous system depression. In severe cases, patients can also

experience hypotension (Scharman, 2012). In the clinical realm, clinicians may underreport

miosis because they rarely assess for this symptom due to the severe medical concerns that the

opioid addicts and people suffering from opioid disorders present with like respiratory arrest.

Relevant Decisions to Implement

To begin with, the government should admit that the opioid epidemic is a national

emergency. From this decision, the government can begin to implement the appropriate measures

through which it can address the opioid epidemic. The government should also decide to regulate

the activities of the pharmaceutical companies and take its independent position. When the

government decides to regulate the rate of production of the opioids by the pharmaceutical

companies, it becomes easy for the government to implement preventative measures alongside

the treatment measures for the disorders relating to opioid use. In the previous section, it is

apparent that pharmaceutical companies are innovating new strategies for pain management. The

government should decide to monitor the progress in these efforts. The government as a

stakeholder and a law enforcement agency should ensure that there are specific time limits within

which the pharmaceutical companies should implement these innovation processes and generate

results. In this decision, the government can regulate access to prescription opioids among

individuals.

Limited access to opioids will enable alternative pain management strategies to gain

popularity. In particular, this means that patients will soon transition to the new strategies for

pain management and avoid their exposure to opioids. In this way, the government, which is the
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key stakeholder in the healthcare sector because of its power and role, can control the exposure

to individuals to opioid use and it can reduce the rate of opioid addiction and opioid-related

disorder. The government can also reduce the rate of heroin addiction and use. Pharmaceutical

companies, on the other hand, should decide to reduce the rate of production of opioids and focus

on alternative pain management strategies (Scharman, 2012). They should decide not to focus

only on profit from the sales of opioids, but also the impact that these drugs have on the lives of

most people that are at risk. It is apparent that all stakeholders now understand the extent of

damage that opioids are causing to society. It is essential, therefore, for the stakeholders to

decide on implementing alternative strategies for pain management to minimize reliance on

opioids.

Constraints

It is evident that the government did not respond to the issues raised by some

stakeholders that the opioid epidemic is a national emergency. Ideally, this means that the

government did not yet accept that the opioid epidemic has reached the level of becoming a

national emergency. In that regard, it is unlikely that the government will address the issue of the

opioid epidemic with the level of seriousness with which it would address a national emergency.

Secondly, although pharmaceutical companies and the administration are aware of the goals and

the plans, they have for alternative pain management strategies, the process is prolonged, and the

benefits of such alternative may take a long time to become a reality. Thirdly, users of

prescription opioids are aware of the possible addiction if they misuse drugs, but they continue

using them. They should decide about the course of their lives on matters concerning opioid use.
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It is evident that the individual patients decide that they want to use opioid drugs only for

the intended reason and for the specified duration, they can avoid the risk of addiction to pain

medication (Rudd, 2016). It is better to prevent the risk of addiction through avoidance of risk

factors than to continue using opioids while expecting to use naloxone to reverse the effects of an

overdose. As a result, this will enable the patients to remain safe while they use pain

management drugs and avoid related opioid disorders. Pharmaceutical companies should decide

to implement the new strategies for pain management and end the overreliance on opioids, which

the patients can abuse. Ideally, having learned that opioid use increases the risk of addiction and

possible development of related opioid disorders, pharmaceutical companies should decide to

implement alternative pain management strategies swiftly.

Potential Unintended Consequences

It is evident that not all stakeholders will always be willing to accept change. It is

especially the case because, in the current opioid epidemic, some stakeholders are benefitting on

their capacities. As a result, if the entire system should undergo the proposed change of avoiding

the use of opioids as the only pain management strategy, the few stakeholders that are currently

benefitting will lose the benefits. To begin with, it is possible for pharmaceutical companies to

oppose the move and develop a bad relationship with individual national leaders. As a result,

their disagreement can go a long way in affecting the political stability in the country because

most pharmaceutical companies normally contribute to decision-making processes (Nova

Recovery Center, 2018). In this regard, they can increase the cost of new strategies for pain

management to the extent that patients can only afford opioid as the preferable alternative.
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Secondly, the leaders that may be benefiting from the bribes given by pharmaceutical

companies alter decision-making at the national level can oppose implementation of government

initiatives like the implementation of alternative pain management strategies by associating with

political decisions. If leaders in Congress, for instance, are among the beneficiaries of dubious

deals with pharmaceutical companies, they can oppose any policy intended to reduce the

production of opioids, and it may take a very long time to succeed. Healthcare providers that

may be benefitting from the dubious acts of the excessive production and prescription of opioids

to unsuspecting patients and the addicts of opioids may develop alternative ways through which

they can execute their deals (Nova Recovery Center, 2018). In particular, this means that other

loopholes can develop, which make it challenging to implement alternative strategies. As a

result, the situation can even worsen following the potential upsurge of illicit trade involving

opioids.

Whom Will Win and Whom Will Lose Upon Implementation of This Idea?

The winner in this proposal is the entire society. Corrupt individuals in the healthcare

system that may be supporting an increased rate of production of opioids and the increased rate

of prescription of these drugs in hospitals will lose. To begin with, the government will benefit

because the public will believe that the government has the power to control the businesses of

pharmaceutical companies in the country. Further, this means that the public will believe that

the government has the power and is willing to protect them from any unscrupulous dealings of

conglomerates in healthcare. The pharmaceutical companies will benefit because they can

develop alternative strategies for pain management, and they can earn trust from the government

and the public. In their actions, they can prove that they are not only aiming to make a profit but
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rather to develop pain management strategies that can benefit patients. They can also earn the

public trust for showing their willingness to address the opioid epidemic in the country.

Patients can benefit by getting an alternative pain management solution. They can avoid

the risk of developing opioid addiction or opioid-related disorders. In particular, this means the

patients can develop a safe way of addressing their pain threats. As a result, they can trust their

government and the entire stakeholders of the healthcare system for promising them a safe

solution to their challenges linked to overproduction and the prescription of opioid in excess. The

media will benefit because they will be among the leading entities in reporting loopholes noted

in the healthcare system that may be threatening the health of patients and the public. If the

public realizes the information given by the media is accurate and true, they develop trust over

the media, and they begin to associate any information that the media provides with a lot of

seriousness. The media will gain by attaining a top position in setting the pace for ethical

reporting in society.

Advantages and Disadvantages of the Idea

Advantages

When implemented, this idea can have several benefits to stakeholders of the healthcare

system. To begin with, it will enhance efforts for the development of alternative pain

management strategies (Rudd, Aleshire, Zibbell, & Matthew, 2016). In this way, it can reduce

the threats of opioid addiction or related opioid disorders among users of opioids. As a result, the

patients will access a safe pain management alternative. Secondly, this idea will ensure that

every stakeholder in the healthcare system plays his or her part well to guarantee patients a safe

pain management program. Thirdly, the government and pharmaceutical companies can pay
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attention to the appropriate business ethics, such that they can operate within the appropriate

business scopes without tolerating any corrupt dealings that lead to unsafe pain management.

Disadvantages

To begin with, the government may need to invest more resources to ensure consistent

oversight on the operations of pharmaceutical companies and healthcare providers. Apart from

incurring an additional cost, which can further increase the cost of the already high expenditure

on healthcare in GDP, the government may intimidate the pharmaceutical companies and

providers, making them uncomfortable in their work. In particular, this can affect the quality of

services offered to patients, and additional threats will emerge in the healthcare system. The

government may also face political hitches because not all stakeholders will agree with the idea

for change (Rudd, Aleshire, Zibbell, & Matthew, 2016). Finally, alternative pain management

strategies may become expensive, and their invention and implementation may be in vain. Even

though the pharmaceutical companies invented and implemented them, the opioids may still

become the preferable options for most providers and patients due to the cost of new strategies.

Summary

The strategy I am developing will help to prevent an overreliance on opioids as the pain

management strategy alone. This strategy will encourage pharmaceutical companies and the

government to implement alternative measures for pain management to avoid the risks of opioid

addiction and related opioid disorders. The proposed change will enhance the commitment of all

stakeholders in the health care system to focus on their respective roles, and they can change the

narrative of the opioid epidemic in the country. This strategy is, therefore, an essential tool
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through which the government and other stakeholders in the health system can solve the problem

of opioid addiction and related opioid infections.

Conclusion

It is evident that opioid misuse is now an epidemic in the country. It is necessary for

stakeholders to develop alternative measures for the management of opioid addiction and related

opioid disorders. Healthcare providers should develop alternative pain management strategies.

The government should take control of the pharmaceutical companies that seem to monopolize

decision-making processes at the national level. The government seems to be lagging in

enforcing regulation to enhance the speed of research to ensure a faster solution to the problems.

Patients with related opioid disorders are suffering for lack of alternative pain management

strategies. They depend on the pharmaceutical companies to give them an alternative for their

pain challenges. The current discussion, however, clarified that the government is slow to

implement change in this process and it should ensure that pharmaceutical companies can work

in collaboration with all stakeholders to develop a lasting solution to the problem facing patients

and the public in terms of opioid addiction and related disorders.

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References

Allen, G. (2017). Should The Opioid Crisis Be Declared A National Emergency?. Retrieved

from https://www.npr.org/sections/health-shots/2017/08/02/541071209/should-the-

opioid-crisis-be-declared-a-national-emergency

National Institute of drug Abuse. (2019). Opioid Overdose Crisis. Retrieved from

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis.

Nova Recovery Center. (2018). America's Opioid Crisis: A National Emergency?. Retrieved

from https://novarecoverycenter.com/addiction/americas-opioid-crisis-national-

emergency/

Rudd, R. A. (2016). Increases in drug and opioid-involved overdose deaths—United States,

2010–2015. MMWR. Morbidity and mortality weekly report, 65.

Rudd, R. A., Aleshire, N., Zibbell, J. E., & Matthew Gladden, R. (2016). Increases in drug and

opioid overdose deaths—United States, 2000–2014. American Journal of

Transplantation, 16(4), 1323-1327.

Scharman, E. (2012). Avoiding the Pitfalls of Opioid Reversal with Naloxone. Retrieved from

https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/avoiding

-pitfalls-opioid-reversal-naloxone