By Don MacGillivray
Recent reports say that Oregon has one of the worst overall drug problems in the United States based on per capita consumption. According to a recent report by WalletHub, Oregon has the sixth worst drug problem in the United States.
In Oregon and across the nation, there has been a dramatic increase in overdose deaths and hospitalizations due to prescription opioid pain medications. An average of three Oregonians die every week from a prescription opioid overdose. Four in five users of illegal drugs start with prescription drugs and become hooked.
Since 2000, a steep increase in prescribing opioids for pain has paralleled this increase in deaths and hospitalizations. More people have started using these powerful medications to treat chronic, non-cancer pain, such as back pain or osteo-arthritis.
This is now a public health epidemic in the same league as cancer and heart disease. Oregon has more drug-related deaths that involve prescription opioids than those related to alcohol, methamphetamines, heroin or cocaine. Those that work with the homeless including the Portland Police Bureau say that the misuse of all opioid drugs are a serious problem here in Portland.
Due to the nationwide concerns, along with greater media coverage, opioids are now prescribed less often due to their serious side-effects and because other treatments for pain are taking their place. This is especially true in the Willamette Valley, but the most serious drug abuse is in rural Oregon.
Sometimes when doctors reduce or end opioid medications the long-term pain patients will buy heroin. This has lead to a high rate of non-medical opioid use by young adults and senior citizens.
Taking too much pain medication can stop a person’s breathing and lead to death. Taking opioids together with alcohol or other sedatives increases this risk. There is a serious problem with unused medications being misused in the home. People who take them, even for short-term acute pain management, can develop an opioid use disorder. Using this type of pain medication can lead to a lifelong struggle with misuse and dependency that will impact a person’s relationships in his employment, family, and in the community.
Since the 1990s doctors have been prescribing opioids as a high reward, low risk pain medication and this led to the situation we are in today. Someone who is given an opioid prescription for 30 days has almost a 50 percent chance of becoming addicted. Most drug users start with prescription drugs. If the doctor refuses to continue the narcotic medication, a patient may choose to use heroin and find that it is both cheaper and easier to get than prescription pain killers.
The habit slowly requires more of the drug to get the same effect. A 25-dollar a day habit can double in a short period of time and the illegal drug user does not know the quality or the potency of the drugs purchased.
In the last year, two new drugs have made problems much worse. Fentanyl and Carfentanil have significantly increased the danger of using illegal drugs. The drug Fentanyl is 100 times stronger than morphine and Carfentanil is 100 times stronger than Fentanyl and overdoses are slowly rising because these drugs are being combined with heroin. These are synthetic drugs that are produced in large quantities in China and they can be purchased online and delivered by the United States mail.
Many people will be able to get help through the Affordable Care Act, but if the program is reduced or eliminated, these people may not be able to access the drug rehabilitation they need. Even so, treatment options are expensive, greatly underfunded, and over capacity making timely treatment difficult if not impossible.
Treatment for opioid addiction are long, difficult, and often unsuccessful. It is similar to trying to give up smoking. A weeklong detox treatment is not enough. What is needed is a three month supervised treatment program with long term follow-up. For the homeless, there are few options available and a week in detox may not be enough.
When someone overdoses an opioid, the pupils in their eyes become very small, they may throw up, they make snoring, gurgling or choking sounds, their breathing gets very slow or stops. They may turn a pale blue-gray and they may become unconscious and not respond to stimulation. This is the time to call 911. The drug naloxone, also called narcan, can quickly revive a person who is suffering from an opioid or heroin overdose.
Opioid use disorder can be successfully treated. If you or a loved one needs help to stop using opioids, talk to your health care provider. The prescription opioid drugs include: heroin, morphine, oxycodone/ oxycontin/percocet, oxymorphone/opana, methadone, hydrocodone/vicodin, codeine, and fentanyl.
If you know someone that might be at risk of a drug overdose, having naloxone on hand could save a life. More information is available from healthcare providers and pharmacists about naloxone. Emergency care through 911 is still necessary as the effects of naloxone are temporary and they will still need medical care as soon as possible. Oregon law protects users from being arrested or prosecuted for drug-related charges based on information provided to emergency responders.
Living Well and other workshops based on the Stanford Chronic Disease Self-Management Program are often effective and available in many Oregon counties. CDSMP workshops are designed to help people improve their ability to control their symptoms and inform them about their health problems. Small-group, interactive workshops are facilitated by leaders who are professionals that have experience with chronic disease.
The Washington Post has recently published a series of articles about drug addiction in America and the September 2017 National Geographic has an excellent article called The Science of Addiction. Both are available via the Internet.