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The Opioid Crisis is Now a Public Health Emergency

President Donald Trump made an announcement at the end of October to the Department of Health and Human Services. This directive was aimed to declare the opioid crisis in the United States a public health emergency. This is a long-anticipated action that addresses the profound, escalating nationwide drug use epidemic.

This vow is set to alleviate the problem of drug addiction and abuse that has swept the United States over the past few decades, and was one of the high priorities of the working-class voters supporting Trump during his campaign. The next step of this process is to escalate further and declare this same opioid process a national emergency, which will prompt allocation of federal funds to address and conquer this problem.

This directive doesn’t release additional funds to deal with the opioid epidemic, which killed close to 60,000 people in 2016 alone. As stated:

“No part of our society, not young or old, rich or poor, urban or rural, has been spared this plague of drug addiction, or this horrible situation that has taken place with opioids. This epidemic is a national health emergency.

As an action initiative to combat this epidemic, President Trump stated that the government would begin to develop advertising that is aimed at persuading American citizens to cease beginning the usage of opioids in the first place. This is almost a call-back to Nancy Reagan’s “Just say no to drugs” campaign in the mid-to-late 1980’s. Trump is quoted as saying:

“This was an idea that I had where if we can teach young people to not take drugs, it’s easier to just not take them. We are going to overcome addiction in America.

Trump also shared the story of his deceased brother Fred, who had struggled with addiction his entire life. Fred had insisted as young adults that the President never drank, advice that he took and has stayed strong to.

The designation of a public health crisis, formally made by acting health secretary Eric Hargan, would allow for some grant money to be used to combat opioid abuse, permit the hiring of specialists to tackle the crisis, and expand the use of telemedicine services to treat people in rural areas ravaged by opioid use, where doctors are often in short supply.

Trump stated that his plan would include requirements that federally managed opioid prescribing facilities be trained in safety practices and protocols for prescribing opioids to patients.  Additionally, the plan would include a federal initiative to develop non-addictive painkillers, and intensify efforts to block shipments of fentanyl manufactured in China into the United States.

Trump also mentioned that the action would suspend a rule currently preventing Medicaid from funding a good number of drug rehabilitation facilities. This action would affect Detox of South Florida and other detox and rehab facilities in a positive way. As stated:

“This cannot be allowed to continue. It is time to liberate our communities from the scourge of drug addiction.

Congressional Republicans as well as law enforcement and physicians’ groups noted that this announcement was a vital first step to building awareness surrounding the crisis, and confronting its causes and life-threatening effects. The chairperson of the AMA’s opioid task force, Patrice Harris, described the act as a move offering necessary flexibility and direct attention to opioid ravaged communities. Harris stated that there is still a good bit of work in the months and years ahead, and that an emergency declaration would serve to add further urgency to the epidemic.

Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University, said that no emergency declaration would do much to alleviate the impact of opioids without a substantial commitment of federal money and a clear strategy for overhauling the way the United States treats addiction. Dr. Kolodny is quoted as saying:

“What is needed is for the president to seek appropriations from Congress in the billions, so that we can rapidly expand access for effective outpatient addiction treatments. Until those treatments are easier to access than fentanyl or heroin, overdose deaths will remain at record levels.

Although Mr. Trump called the opioid crisis a national emergency over the next month, he did not sign a formal declaration of the designation, and the idea ran into stiff resistance in his administration to making an open-ended commitment of federal funds to deal with an issue that has shown no signs of abating.

Administration officials argued that a national emergency declaration was not necessary or helpful in the case of the opioid crisis, and that the powers associated with a public health emergency were better suited to address the issue. They said the White House would soon send Congress a request for money to combat opioids, with the goal of including it in a year-end spending package.

Beyond the lack of funding, it is unclear how much impact this declaration will have in the short term, given that the President has yet to name key players who would bring it to fruition. That includes a drug czar present to steer strategic opioid treatment operations, and a secretary of health and human services to tailor policies and identify sources of funding.

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Additional related materials:

What are opioids?

Opiates Vs Opioids

First off let’s define Opiates vs Opioids. Opiates are drugs derived from the opium plant. In earlier years opioids stricly meant synthetic opiates. These were created in a lab, thus the term synthetic. They were designed to behave like opium, but on a base level they are different.  Today however, the term Opioid is used to describe the whole family of opiates. Both natural synethetic and hybrids (semi synchteic).

Opioids are drugs that affect the opioid receptors in the brain and in the spinal cord. They reduce the intensity of the pain and how the body responds to it. Opioids also work in the brain areas that control emotions, it can further decrease the painful stimuli.

For centuries, medical practitioners used opioids to treat a cough, pain even diarrhea.

Typically, opioids are used to treat acute or severe pain. Since the 90s opioids have increasingly used as a treatment for chronic pain. Even if little evidence proving its effectiveness.

Correspondingly, there are reports that people suffer from an illness known as hyperalgesia.  Hyperalgesia is a condition which increases a person’s sensitivity to pain because of opioid treatments.

Aside from relieving pain, opioids also affect the reward system of the brain resulting in a state of euphoria. Providing this kind of ‘high’ feeling is one of the main reasons for the misuse of the drug that eventually lead to addiction.

Opioids contain the same chemical components of heroin. These drugs first synthesized from morphine in the late 19th century. Similarly, these properties present a greater risk of addiction and overdose. Even when a person is following legitimate prescriptions.

How opioids influence the brain and body?

Opioids work in attaching themselves to the opioid receptor proteins. These are found on the nerve cells in the spinal cord, brain, digestive system and other organs in the body. Once attached to the receptors, they decrease the pain signal transmissions.

Known effects of opioids include:

  • sleepiness/drowsiness
  • mental confusion
  • nausea
  • constipation
  • respiratory distress

 

Also, opioids affect the reward system in the brain inducing euphoria. When taken in higher dosages or administered in other ways than prescribed it can intensify its effects.

Some people take drugs in other ways than prescribed to intensify its effects.  For example, a drug was prescribed as an oral medication to have a steady, constant release of the opioid. People often change its form in preparation for injecting or snorting the drug.  It generates a greater chance of getting medical complications even drug overdose.

The Case of Drug Overdose

In 2012, heroin addiction plagued the United States. More than 2 million Americans suffered from opioid painkiller abuse. Opiate abuse can result to many health complications and more often than not leads to death because of overdose.

Effects of Opiates in the Body

Effect of Opiates in the brain

The side effects of opiate painkillers can induce daytime sleepiness or drowsiness.

 

  • Heroin can cause intermittent attacks of “nodding off”. Users can sometimes slip in and out of consciousness.
  • This can cause accidents when the users are in the dangerous environment. For example when a user nods off when driving, swimming or working in heavy machinery.
  • Users who abuse opiates for more than six months had an increase chance of 50% greater developing depression attacks.

 

Effect of Opiates in the   Respiratory System

  • opiates can result in respiratory distress, a condition which slows down breathing and can lead to death
  • even in adequate doses, drugs can take away the proper supply of oxygen in the brain and body tissues of oxygen

 

Effect of Opiates in the  Digestive System

  • opiates disturb the digestive process and can lead to constipation because of the slow movement of the digestive track
  • The slowed movement can lead to more serious health complications.
  • like bowel obstruction, peritonitis even bowel perforation
  • Abusive use of opioid painkillers can cause involuntary vomiting and nausea

 

Effect of Opiates in the Nervous System  

  • people who develop hyperalgesia can have an increased sensitivity to pain
  • opioids can lead to psychomotor disability, which slows down the physical movement of a person
  • drug abuse of opiates can also generate loss of body coordination

 

Effect of Opiates in the Immune System

  • opioids can weaken the immune system
  • This can lead to the exposure to infection because opioid receptors engaged in the regulation of immunity.

 

 Effect of Opiates in the   Liver

  • acetaminophen in painkillers like Vicodin and Percocet can cause liver damage
  • another harmful effect of opiates in the body is when the drug is mix with alcohol. The mixture can promote reduction of the liver’s ability to process the chemical of the toxic combination of ethanol and acetaminophen

 

The Effects of Injecting Opiates

  • injecting heroin or crushed pills into the system can cause interstitial lung disease

septic pulmonary embolism and tuberculosis infection

  • sharing needles can lead to hepatitis C and a higher chance of contracting HIV
  • Chronic heroin or injecting crushed pill can lead veins to collapse
  • injection of heroin can lead to an infection in the heart’s lining known as endocarditis
  • contaminants in heroin can block blood vessels and can cause organ failure

 

 

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