The History of Opiate Addiction
Grand Canyon University: <PCN-527>
January 17, 2018
Introduction
Opiate addiction in America has
become one of the hottest topics because of the death rate and destruction
caused by these drugs. The history of opiates is complicated, and laws have
been passed and thrown out due to the topic. The psychopharmacology of opiates
is discussed through the view of detoxification including terms of how to
manage tolerance levels and withdrawal symptoms. Current trends and issues
arise in the political view of health care and how opiate addiction effects
society in a negative manner. With health care being a hot topic in congress
today the issue of opiate use is slowly being addresses from the dollar expense
view of the health care system. Medication Assistant Treatment (MAT) is used in
professional counseling arenas to aid clients in detoxification and becoming
healthy and clean. Without strict legislative measures passed, America is
looking at a long-term addiction that many will die from and the financial
implications are troubling for health care and tax payers.
The
History of Opiates
When opioids first hit American
soil in the late 1800s, they were hailed as a wonder drug., and morphine was
widely used in wars and created addicts by the dozens. David Courtright’s vast
knowledge of how America became in a sort of romance with these compound drugs,
mainly opiates are clear account of the road these drugs took in America. There
are arguments that claim demographics and the ease of obtaining these drugs
have affected the U.S. drug policy, and this has become a topic that has
stretched from the past to the present, (Campbell, 2003). In the last 50 years,
America has watched the opiate addiction move from the inner cities to a
demographic including outside urban areas with an age range from the late 20’s.
This included White women and men that had not been drastically affected
before, (Cicero, et al, 2014). “Heroin use has changed from an inner-city,
minority-centered” (A Retrospective Analysis of the past 50 years, p.821). The
dramatic rise in heroin has happened in just the last 20 years. This mostly due
to the interrelationship between prescription opiates and the cheaper to get
heroin on the streets. Oxy Cotton has been to blame because of its very release
into the pharmaceutical world at an extreme rapid rate. According to the studies
conducted by Cicero, et al, 2014, “Of those who began their opioid abuse in the
1960s, more than 80% indicated that they initiated their abuse with heroin. In
a near complete reversal, 75% of those who began their opioid abuse in the
2000s reported that their first regular opioid was a prescription drug, (p.
823). The prescription drug world added to the black-market drugs and took a
destructible hold on these communities and families.
The next issue of dealing with
opiates and the help needed for addicts is how to deal the psychopharmacology
of Opiates.
Psychopharmacology of
Opiates
The whole focus is to eliminate the
effects of opioid drugs in a safe and effective manner. All opiates, including
heroin and methadone, are agonist that stimulate opioid receptors.
Buprenorphine is a partial agonist at the ยต opioid receptor subtype, which
means that the system is not fully stimulated even when all the receptors are
occupied. Dependence and withdrawal of opiates of all types have been studied
closely by Holmes, et al, (2012). Buprenorphine is worth highlighting in this
context for its pioneering contributions to addiction treatment, (Volkow,
2014). Galanin which is neuropeptide, which is expressed in the
hypothalamic-pituitary-adrenal axis and in the central nervous system, which
also affects the limbic system. This means these all the areas of the brain
that regulate the reward centers which affects addicts on opiates. They
concluded that galanin needed to be addressed when treating addicts with opiate
addictions.
Methadone
has been used for years to combat many of these addictions yet as found in
Canada only 25% of addicts will even attempt to get this treatment, and, “in
North America, only about 20-25% of the estimated heroin
user
population are in opiate pharmacotherapy/methadone treatment”, (Fisher, et al,
2002, p 496). The motivation behind this thinking is might be that they hear
bad information from others, fear being arrested as addicts, social concerns,
e.g., hiding their addictions to not lose jobs or family. Functioning
prescription addicts exist among us in all walks of life. With the current
trends and issues in America dealing with opiate abuse the future is looking
bleak.
Current Trends and
Issues in America dealing with Opiates
Current trends have this issue in the news
daily and was a big part of the 2016 Presidential race. According to Volkow
(2014), “It is estimated that between 26.4 million and 36 million people abuse
opioids worldwide with an estimated 2.1 million people in the United States suffering
from substance use disorders related to prescription opioid pain relievers in
2012 and an estimated 467,000 addicted to heroin,” (para. 3). It is common
knowledge that when legislative bills have been presented to congress to reduce
the opiate crisis, lobbyist from the pharmaceutical companies have won by using
bribes at fund raising dinners for politicians running for office. The idea is
that it is legal to pay $20,000 dollars for a dinner when they are paying to
have their own needs met in the opiate war. These prescription opiates have
caused more deaths than heroin or cocaine in just the last 25 years. Opioids
include drugs such as OxyContin and Vicodin that are mostly prescribed for the
treatment of moderate to severe pain, in which once a person is on these widely
prescribed drugs and their prescription is expensive they turn to the streets
to get more affordable drugs and their tolerance level is now higher, (Volkow,
2014).
Professional of the counseling
fields are integrating drug treatment plans to combat this horrific addiction.
The use of office based settings to safely treat opiate users with the goals of
lowering their tolerance levels is another tool used to fight this deadly
addiction. Medication-assisted treatment will be most effective, (Volkow, 2014 Integrating
Drug Treatment into Healthcare Settings). Strategies being used to combat
addiction include making needles free and available to users so other issues
such AIDS are reduced amongst users. According to Kosten, 2005, “the U.S.
federal government has not embraced this harm reduction approach, and in many regions of the country
prescriptions are still required for the purchase of needles,” (p. 308). States such as California have this policy
but usually these privately funded programs are hard to come by. The urgency is
just not appreciated by many societies. Issues still being faced are as
follows:
·
Low-support
for treatment reduction plans
·
Lobbyist
still paying to keep pumping these drugs in high rates to treat patients
·
Current
administration’s lack of concern for addicts
·
Current
funding to aid is just not approved by Congress
·
Buprenorphine
is so highly limited to about 30 patients per doctor that doctors call it a
ridiculous waste of time, (Vastag, 2003).
All the above issues play a role in this
devastating crisis still killing so many people daily. Take home medications,
and certain prescriptions are not being allowed in widespread forms to help the
millions addicted to opiates. Doctors must take more courses on drugs that do
work and being limited on when and where these coarse can be taken has caused
another block on safe and effective treatment for addicts. As Lighthall, 2017
observes the word “epidemic” he states, “from the Greek translation, something
that is over and upon the people,” (The True Tale of America’s Opiate
Epidemic). The Opiate epidemic is truly upon and over us now. How opiate
addictions affect society and families is a concern because the devastation can
be seen nation-wide.
How Opiates Effect Society and Issues that
are Relevant
Substance exposed newborns present challenges for
hospitals. Detoxification for babies is a long-term complicated problem that
requires the babies to stay in the hospital long after the addicted mother is
released. This in-patient care and presents a financial burden on the
hospital’s and the medical field in general. The long-term health issue for
these children affected by opiate abuse means they will need care all through
their lives and this costly to America’s health care system. According to
Franca, Mustafa, and McManus, 2016, “Increasing opiate use among women of
reproductive age has led to a rise in adverse pregnancy outcomes, including
neonatal abstinence syndrome (NAS),” (p. 80). When a child is reported as an
opiate addicted baby, the report is mandatory to be sent to child and family
services which means the child is now placed in the system and the addicted
mother must prove her self to get the baby back. This includes moths of treatment
programs, inpatient and outpatient, court dates to follow up with addicted
mother, families are torn apart, and sadness is inevitable. These take a toll
on society both financially and psychologically.
Crime and Opiates
There
is a relationship between all drugs and crime including alcohol. Recently the
relationship with crime and opiate abuse has been reported to be daily. Some of
the crimes committed include:
·
Child
abuse
·
Driving
under the influence of opiates both prescribed and illegal Heroin is a bargain, at least in
the beginning stages of addiction. A single “hit” (or bag) is currently about
$10.
·
Purchasing
of cheaper street drugs
·
Stealing
from people and commercial places to obtain drugs
·
Identity
theft/credit card fraud
·
Domestic
violence, e.g., families in crisis
The counseling profession is very involved
in the attempt to eradicate opiate use and help addicted persons to get this
monkey off their back.
The
Counseling profession and Opiate Relevance
Ultra-rapid
and rapid detoxification using precipitated withdrawal should not be routinely
offered. Settings at home are dangerous when users try to detox, and the mix of
other drugs can cause fatal outcomes.
According to “The Austrian method is used to detox and has window of 12
hours for the patient to stay clean until the procedure in attempt to reduce
the withdrawal attributes. This is usually summed up as a sedation method.
Davis (2005), “In 1988,
Austrian physician Norbert Loimer was studying opiate withdrawal when he discovered
that injecting addicts with naloxone – the intravenous form of the opiate
blocker naltrexone – achieved what he referred to as “acute detoxification.” (detoxification).
This method has had proven success and has been referred by the counseling profession.
Effective treatment focuses on the genetic
and environmental causes of addiction. Basically, we are right back to the
nature versus nurture issue. Counseling also treats the physical and mental
side-effects of opiate addictions. Counselors seek to fins the underlying
reasons why the person began opiates even when there is an accident that
started the person first on prescription opiates. The next step is why the
person continued and became an abuser of the medication. The future
implications of opiate use are bleak because of political issues and the old
famous art of greed by lobbyist.
The Future
Implications of Opiate Abuse in America
The
implications are devastation in the following ways;
·
Economic
issues on the country
·
The
long-term effect on persons addicted
·
Total
U.S. expenditures that include multiple diseases caused from opiate addictions
The economic issue is widespread because
of all the factors that are born from people that are addicted. By this, there
are HIV, babies addicted, chronic illness from the drugs that affect every
aspect of the body and the care that is needed to treat the issues. This is a
heavy burden on a society that already faces nation debt at an alarming rate.
Today’s administration is bent on cutting back money from programs that help
afford care to people that have addictions to opiates even when most are from
prescriptions handed to them in a careless manner. If America does not show the
medical compassion needed to handle this addiction issue and eradicate from our
society we will face a country that can possibly implode from opiate
addictions. Opiate addiction has touched the lives of all walks of life in this
great country and to heal we need to learn, listen and help. Our future
counselors are part of the solution if they are respectfully heard.
Conclusion
Opiate
addiction has become the worst addiction to hit America since the early 1800’s.
When morphine was used as a go-to drug for our military and later citizens. The
history of these drugs along with pharmacology, current trends, issues,
relevance to the counseling profession and the future implications of this
deadly drug look bleak if more attention by our federal government is not
acquired. The destruction of families in all functions including new born
babies and the long-term effects this drug has is at a critical point in our
history of this these drugs. Many doctors disagree of which methods are
effective and some of these reasons are because of the amounts of preventive
care or sedation methods that can be administered. The 30-patient rule per
doctor to receive buprenorphine is so highly limited to about 30 patients per
doctor that doctors call it a ridiculous waste of time, (Vastag, 2003).
Politicians and lobbyist are in a money world to meet the needs of greedy
politicians and pharmaceutical companies that have no morals when confronted
with the devastation caused by opiates in America. To beat this opiate killing
addiction in America we need minds of counselors and doctors to stand up and
fight to rid out country of this deadly drug called opiates. Alternative pain
relievers are available.
References
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