Index Prescription Opioid AddictionThe Opioid CrisisConclusionOpioids are one of the oldest natural drugs in the world with the earliest known record coming from modern Iraq around 3000 BC According to Hardey, opiates have been used medicinally for thousands of years to treat pain; however, it was not until the 20th century that a dramatic spike in illicit use occurred (2019). Opioids are a class of drugs that act on endogenous opioid receptors to produce a myriad of effects, with the most notable effect being analgesia, or pain relief (CDC, 2018). Opioids come in many forms, such as natural, semi-synthetic, and fully synthetic. Semi-synthetic opioids are synthesized from natural opiates, such as codeine and morphine, and include drugs such as hydrocodone, oxycodone, and heroin. Opioids can also be completely synthesized in the laboratory without naturally occurring opiates; furthermore, methadone, fentanyl and naloxone fall into this class. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay In the United States, the legal status of opioids has changed over the last century. In 1906, the Pure Food and Drug Act allowed the federal government to oversee the manufacturing and shipping of drugs for the first time, and with the addition of the law, the Food and Drug Administration – or FDA – was created. In 1971, Congress passed the Controlled Substances Act, which created schedules I through V for drugs based on their currently accepted medical use and potential for abuse (DEA). Schedule I is the highest and includes drugs that currently have no accepted medical use and are believed to be more addictive. Schedules II through V include drugs available for medical use, and the potential for abuse decreases with each schedule. Currently, heroin is the only opioid not available for medical use, primarily due to its highly addictive nature; therefore, heroin is classified as a Schedule I drug in the United States. Other opioids such as morphine, hydrocodone, oxycodone, and fentanyl are available for use by prescription. However, all opioids are highly addictive, so they are still classified as Schedule II (DEA). Additionally, in an effort to limit the availability of these drugs, Schedule II and III drugs are available only by written prescription. However, Soelberg, Brown, Vivier, Meyer, and Ramachandran argue that electronic prescriptions for narcotics would be easier to monitor and regulate (2017). The authors argue that providers often prescribe more than needed for a patient so that he or she does not have to return for an office visit to receive more medications. On the other hand, if narcotics were available via electronic prescription, patients could more easily obtain a refill, which would allow for better monitoring of doctors' prescribing and patients' opioid use. Overall, prescription drug regulation is not perfect, but it has improved dramatically over the last century, even more so over the last decade. Prescription Opioid Addiction Although opioids are only legal in the United States by prescription, there is a massive black market for prescription drugs. prescription opioids. Opioids are a highly addictive substance that can easily lead to abuse even if initially prescribed by a doctor. According to the National Institute on Drug Abuse, prescription opioid abuse is characterized by one of the following: Intakeof opioids in a way other than how it was prescribed, taking a prescription that was not intended for you, or taking the drug for “high” effects and unwanted therapeutic effects (2019). According to Ling, Mooney, and Hillhouse, an estimated 13.8 million people over the age of 12 have tried oxycodone for non-medical reasons in the United States (2011). Furthermore, according to the authors, there was a 400% increase in hospitalizations for opioid abuse from 1998 to 2008 (2011). Ling, Mooney, and Hillhouse stated, “The widespread availability of prescription pain medications, coupled with public misconceptions about the safety and addictive potential of these medications compared to illicit opioids, are factors contributing to the recent increase in non-medical use of prescription opioids”. ” (2011). Overall, these facts reveal that in the 21st century there has been a dramatic increase in opioid use and addiction. Opioids alter the way the nervous system works and interacts with the body and, with prolonged use, opioids can dramatically change the internal functioning of the nervous system. Therapeutic effects of opioids can include pain relief, cough suppression, reduction of anxiety, and euphoria side effects associated with taking opioids such as slowed breathing, confusion, constipation, nausea, and itching (National Institute on Drug Abuse, 2019) One of the major effects of taking opioids for a long period of time is tolerance (CDC,). 2018).Tolerance is when a person needs to take more drugs to get the same effects. Also, with repeated use, a person can develop an addiction to opioids. Addiction occurs when the body and nervous system have adapted in such a way that they do not function normally without the presence of the drug. When a person's life is centered around a drug that leads them to continue using it despite adverse or harmful consequences, that person will be considered addicted. Drug addiction, or substance use disorder, is a chronic disease that can be extremely difficult to manage, and opioids are one of the most abused narcotics in the United States. The Mayo Clinic defines a substance use disorder as “A disease that affects a person's brain and behavior and leads to the inability to control the use of a legal or illegal drug or medication” (2017). A study by Fleming, Balousek, Klessing, Mundt, and Brown sought to explore the effects of daily opioid therapy on patients, specifically whether or not they developed a substance use disorder resulting from prolonged opioid use (2007). The authors conducted interviews with 800 patients with diagnosed chronic pain who received daily opioid treatments under the supervision of a primary care physician. The Diagnostic and Statistical Manual of Mental Disorders – IV (DSM-IV) was used during the interview to determine whether participants met the criteria for receiving a diagnosis of substance use disorder or opioid dependence. Study results show that those currently receiving daily opioid therapy for chronic pain are three times more likely to develop a substance use disorder than the general population (3.8% vs. 0.9%). Furthermore, the authors found that 24% of participants also tested positive for other illicit drugs in addition to opioids, suggesting an association between substance use disorder and illicit drugs. Additionally, nearly half of the participants who tested positive for illicit drugs lied to researchers about their usedrugs even when promised anonymity. This finding suggests that patients with chronic pain may be misleading their doctors when it comes to illicit drug use. Overall, the authors report that the risk of developing a substance use disorder does not outweigh the benefits of daily opioid therapy for most patients. Additionally, they advocate daily use of opioid treatments under a doctor's supervision to treat chronic pain. The Opioid Crisis Around 2010, it was evident that there had been a sharp spike in the number of prescriptions written for opioids and the number of people taking and/or addicted to opioids. prescription opioids and the number of deaths due to opioid overdoses since the drugs first hit the market in the late 20th century. As the numbers increased, it was obvious that there was an opioid crisis in the United States. Loisel describes the onset of the opioid crisis in the early 21st century as a combination of all opioid prescribing, the introduction of fentanyl into mainstream treatment, and a spike in heroin-related overdoses and deaths (2019). According to Loisel, when marketing opioids in the 1990s, pharmaceutical companies claimed that opioids had low abuse potential and were safe to prescribe to patients as pain relievers (2019). Because of marketing, doctors began prescribing opioids, such as hydrocodone and oxycodone, often for pain, which largely contributed to the start of the opioid crisis. Additionally, in the early 2000s, fentanyl, a synthetic opioid, became very popular. Fentanyl is a fully synthetic opioid typically used to treat chronic pain when a patient has developed a tolerance to traditional semi-synthetic opioids. This drug is extremely potent, and without tolerance, it is very easy to overdose on fentanyl. With the introduction of fentanyl into modern medical care, it has become much easier to obtain and has started to appear on the black market. One of the biggest problems related to the opioid crisis is the lack of long-term research into treatment options for opioid addiction. A study by Weiss et al. sought to understand how different courses of opioid treatment affected the likelihood that participants would abuse the drug again (2015). One thing that sets this study apart from others on opioid addiction treatment is that the researchers followed participants during the treatment itself and then for 42 months in order to compile short- and long-term data. In the study, the authors focused only on patients with prescription opioid addiction and not on patients with heroin addiction. The first treatment tested in the study was a standard medical management (SMM) treatment. SMM included regular visits to the doctor, buprenorphine-naloxone, a drug to treat narcotic addiction, and counseling. The second treatment tested was SMM plus individual opioid drug counseling (ODC). ODC treatment included everything in SMM treatment, but with more in-depth counseling focused on relapse prevention, help with withdrawal symptoms, and lifestyle changes. The participant underwent SMM or ODC treatment and received check-ins at 18, 30, and 42 months after treatment. This document did not specifically discuss the results between the different treatment groups, but the overall results at the end of the study. Long-term monitoring allowed the authors to get a more complete picture of what happens once a patient is off therapy and.