U.S. drug crisis is now pushing up death rates for almost all groups of Americans

June 19th, 2017

The Opioid Crisis Continues to Grow

by David Kan MD DFASAM (Distinguished Fellow of the American Society of Addiction Medicine)
forensic psychiatrist, fpamed

The opioid crisis continues to grow. Recent data from the Centers for Disease Control show that overdose death rates have risen in every ethnic group. The most recent CDC data show that deaths as a result of opioid overdoses have exceeded homicide and motor vehicle accidents as leading causes of preventable death. There are many reasons for these spikes. The medical industry owns part of the problem as a result of overprescribing of opioid painkillers. The data relied upon to justify such prescribing practices was shaky at best. Now, with the benefit of hindsight, we find that the benefits of opioid analgesics for pain were overblown and the risks minimized.

There is a second factor at play. Compton and others point out that while most people who use heroin have used prescription opioids prior to using heroin, there are market forces at play that have conspired to push heroin to the forefront. The narrative that doctors have single-handedly created this epidemic breaks down when you see the evidence. In short, drug cartels have learned that in bringing in the supply of heroin, you create the demand for heroin.

There is a massive gap between people addicted to opioids and the number of available treatment slots. Medication Assisted Treatment (MAT) with medications such as buprenorphine and methadone are the gold standards for managing opioid addiction. These treatment options are limited in terms of certified physicians and treatment program slot availability. The issue of stigma is also another barrier to treatment. Stigma cuts both patients and providers as well. Detoxification is of limited long-term success in patients with severe opioid use disorders.

It is time that we embrace the evidence and embrace the full spectrum of treatment options with the emphasis on MAT as a minimum. Lives are being lost as we insist on detoxification. Detoxification is the first step to recovery. Getting abstinent is easy. Staying that way is the work – something that all addiction specialists recognize.

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