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The Opioid Epidemic

Did you know that the #1 cause of death in America for men between the ages of 35 and 54 is by drug overdose, and that the #1 type of overdose is from opioid medications? New York City firefighters and
EMTs who sustain orthopedic injuries in line-of-duty or car accidents are not immune from this epidemic. Sadly, many of our friends and clients have been affected. To understand the extent and severity of the opioid crisis in our country, you need only know a few key facts:

The United States accounts for approximately 4.6% of the world’s population but consumes 80% of the
global opioid supply.

Americans are six times as likely to die from a prescription drug overdose as from a heroin overdose, and twice as likely as from a cocaine overdose.

Drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017.

In large part, this trend has to do with a change in the perception of pain within the medical community. Whereas, in the past, pain was viewed as a symptom, it is now classified as a condition. And because, ‘chronic pain’ has become a commonly accepted diagnosis, the treatment of pain has become far more extended. Prescribers are issuing more prescriptions for opioids, over longer periods of time and in higher doses.

Compounding the danger, there are large unused quantities of opioids being stored in unsecured medicine cabinets in many people’s homes.

Opioid use also causes physical dependence, which differs from addiction. Addiction, i.e. compulsive use despite harmful consequences, is characterized by an inability to stop using a drug. Physical dependence means the body’s adaptation to the drug, requiring more of it to achieve a certain effect and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased or tapered, i.e., withdrawal. A standard opioid prescription allowing for dosage at 3-4 times a day for two weeks can make a patient physically dependent, and withdrawal can cause panic attacks, depression, anxiety, diarrhea, sweating and insomnia. Also, functioning declines with long-term use and typically dosage requirements increase simply to stabilize the user.

Of course, opioids work well at controlling pain. That’s why they have become so widely prescribed. The
point of this article is not to suggest that opioids should be banned. But, as the expression goes, forewarned is forearmed. The more you know about the risks associated with opioid use, the better you can guard against them. Use opioids with extreme care and only as directed by your doctor. Discard any unused opioids in your home. And use opioids only as a last line of treatment.

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