Opiate Education: Key Points for the Pharmacist
Opiate Education: Key Points for the Pharmacist
Over the last two decades, there has been a steady increase in the total number of opioid prescriptions. From 1991 to 2010 the number of opioid prescriptions increased sixfold, from 30 million to 180 million prescriptions. Concurrent with this growth in opioid prescriptions has been an increase in diversion and nonmedical opioid use. In 2009, an estimated 5.3 million persons were taking pain relievers for nonmedical uses. In 2010, nearly 5% of the U.S. population aged 12 years and older was taking an opioid pain reliever for nonmedical purposes.
In the U.S. in 2007, nearly 100 people died each day from a drug overdose. According to the CDC, death rates from opioid overdoses have more than tripled since 1999. Increased opioid use has contributed to the increase in overdose-related deaths (Figure 1). Opioid pain relievers currently account for more overdose deaths than heroin and cocaine combined.
(Enlarge Image)
Figure 1.
Increase in Opioid-Related Overdose Deaths
Not everyone receiving opioids will develop an addiction; however, certain biological and environmental risk factors increase the likelihood of substance abuse. Males are 1.5 times more likely to become dependent on opioids. Psychological conditions such as depression, anxiety, attention-deficit/hyperactivity disorder or attention-deficit disorder, and posttraumatic stress disorder confer an increased risk of addiction, as the sufferer may use drugs to cope with the condition. Peer pressure and lack of family involvement are environmental risk factors that may predispose a person to substance abuse.
Opioids are safe and effective for pain management when taken as prescribed. However, these drugs can cause severe adverse effects—including drowsiness, slurred speech, confusion, respiratory depression, and even death—in cases of abuse. Opioid withdrawal symptoms may occur following dose reduction in chronic users or upon abrupt cessation. The onset of withdrawal symptoms varies depending upon the specific opioid used and occurs from hours to days after cessation. For example, with heroin, withdrawal symptoms can occur within 1 to 3 hours, while with methadone they may not appear for 3 to 5 days. Withdrawal symptoms are listed in Table 2.
Opioid Dependence
Over the last two decades, there has been a steady increase in the total number of opioid prescriptions. From 1991 to 2010 the number of opioid prescriptions increased sixfold, from 30 million to 180 million prescriptions. Concurrent with this growth in opioid prescriptions has been an increase in diversion and nonmedical opioid use. In 2009, an estimated 5.3 million persons were taking pain relievers for nonmedical uses. In 2010, nearly 5% of the U.S. population aged 12 years and older was taking an opioid pain reliever for nonmedical purposes.
In the U.S. in 2007, nearly 100 people died each day from a drug overdose. According to the CDC, death rates from opioid overdoses have more than tripled since 1999. Increased opioid use has contributed to the increase in overdose-related deaths (Figure 1). Opioid pain relievers currently account for more overdose deaths than heroin and cocaine combined.
(Enlarge Image)
Figure 1.
Increase in Opioid-Related Overdose Deaths
Not everyone receiving opioids will develop an addiction; however, certain biological and environmental risk factors increase the likelihood of substance abuse. Males are 1.5 times more likely to become dependent on opioids. Psychological conditions such as depression, anxiety, attention-deficit/hyperactivity disorder or attention-deficit disorder, and posttraumatic stress disorder confer an increased risk of addiction, as the sufferer may use drugs to cope with the condition. Peer pressure and lack of family involvement are environmental risk factors that may predispose a person to substance abuse.
Opioids are safe and effective for pain management when taken as prescribed. However, these drugs can cause severe adverse effects—including drowsiness, slurred speech, confusion, respiratory depression, and even death—in cases of abuse. Opioid withdrawal symptoms may occur following dose reduction in chronic users or upon abrupt cessation. The onset of withdrawal symptoms varies depending upon the specific opioid used and occurs from hours to days after cessation. For example, with heroin, withdrawal symptoms can occur within 1 to 3 hours, while with methadone they may not appear for 3 to 5 days. Withdrawal symptoms are listed in Table 2.