Hi! This is my ENG 102 argumentative research essay about opioid policies. I would appreciate feedback on organization, repetition, clarity, and whether my argument remains focused. Thank you!
Over time, the use of opioids has continued to grow. It has taken over the initiatives used to control it, and we are constantly left to find new solutions to the problem. Opioids have been an ongoing "trend" starting with prescription opioids, leading to a downhill spiral to heroin and illegal drug use, including fentanyl. In 2023, there were roughly 80,000 deaths from overdose out of the 105,000 drug related deaths ("Understanding the Opioid Overdose Epidemic). Even though this statistic is not near the numbers in previous years, it is still 10x higher than in 1999 ("Understanding the Opioid Overdose Epidemic). Using these statistics, it shows that the crisis is the result of more than just lenient prescriptions and illegal drug dealing. Even with an increase in monitoring from healthcare providers, the problem still persists. With effective marketing, more treatment options and extended education on naloxone, fewer lives would be lost, and more people can receive the help they need.
The epidemic began with a belief that these medications would be the most effective and safest way to treat pain. By minimizing the dangers of addiction or dependency, pharmaceutical industries were able to encourage the use of opioids through marketing and sugarcoating. ("Overprescribing Opioids and the Opioid Epidemic"). Because of this, doctors were prescribing in higher doses than needed, and individuals were taking the medications without knowing the potential dependence they were developing. They believed that the prescription given to them by their doctor was safe. The history of the crisis is important to consider because many think it was caused by the patients' behaviors and decisions, but that's not the case. The drug manufacturing companies, regulatory agencies and healthcare providers led to the increased availability of the drugs. Future policies need to take into consideration the spread of misinformation and educating their patients instead of just blaming those that are dependent. (Overprescribing Opioids and the Opioid Epidemic)
According to the CDC, the epidemic of opioid overdoses has been made up of three different waves, all within relation to each other. The first wave seems to have started in the 1990s with an increase in prescription opioids. The result of this was an increase in deaths from the use of these medications. Then around 2010 the next wave began. The abuse of heroin took communities over by storm, and the heroin related deaths continued to climb. Finally, starting in 2013, synthetic opioids and illegally produced fentanyl. Fentanyl has been found in many street dealings, sometimes formed into counterfeit pills or mixed within different drugs unknowingly ("Understanding the Opioid Overdose Epidemic"). The progression of these waves going from prescription opioids to heroin or fentanyl shows the major flaws in only focusing on one opioid at a time. Although it all seems to have started due to the over prescribing of these medications, addressing only that issue does not end addiction or individuals finding these drugs other ways. In many cases, individuals who could no longer obtain a prescription would transition to other alternatives (Kharasch).
With the transition from one to the other becoming more common, there should be consideration for OUD, Opioid Use Disorder, to be seen as a medical condition rather than just criminal behavior. Opioid use disorder changes how a person responds to things like cravings, withdrawals, stress, decision making and risk factors. The worst part is that a person with this disorder may continue using opioids even after causing damage to their health, social life, or finances. Criminal punishment alone cannot help with these ongoing factors; there needs to be options for treatment, medication therapy, counseling or other helpful outlooks ("Preventing Opioid Overdose"). As revealed by Kharasch and his team of coauthors, the current policy shows that the reduction of prescriptions has consequently led to an increase in death from opioids. Kharasch argues that the policy is specifically based on the decrease in the number of prescriptions and doesn't take into consideration the constant change in street dealings and those who are dependent needing help (Kharasch). A public health response is more likely to reduce harm because it would focus on prevention and recovery, instead of waiting for the individual to end up in the criminal justice system.
One of the best resources to come out of the initiatives taken was the Prescription Drug Monitoring Programs or PDMPs. They provide us with information linking controlled substance prescriptions using a statewide database. Physicians can check the patient's prescription history and base therapy from the findings. With this, there can also be information that would reveal malpractice or any suspicious activity from providers. This being duplicate prescriptions, refill requests before acceptable prescribing time, too high of dosing, or prescribing of drugs that could cause overdose (Public Health Considerations for Strategies and Partnerships). Puac-Polanco and other authors reviewed 29 different papers on the information provided from prescription drug monitoring programs. Most studies showed that there were less prescriptions once the program was introduced, but the number of deaths seemed to not change. Only 4 out of 8 studies showed a decrease in opioid-related deaths (Puac-Polanco). This mixed result does not mean that drug monitoring programs are useless, but more about how providers should use this information to connect patients for safer pain management or addiction treatment when presented with the warning signs. Not just strictly based on the programs.
The current fentanyl epidemic makes the use of warning signs and using resources even more important. Prescription Drug Monitoring Programs can track medications given to patients through a healthcare provider, but it cannot identify a counterfeit pill purchased illegally or what other substances could be mixed within them. According to the CDC, illegally produced fentanyl has become so popular within the black market and is often created to mimic legitimate prescription drugs (Understanding the Opioid Overdose Epidemic"). Because of this, people purchasing these pills in hopes of taking oxycodone, for example, end up consuming fentanyl-based tablets which could contain an unpredictable and potentially life-threatening amount of fentanyl. At the same time, the individuals who want to seek help might face many obstacles, prior authorizations, limitations from insurance, lack of healthcare, or even being stereotyped by healthcare providers (U.S. Government Accountability Office). The repercussions of the obstacles lead to difficulty in starting and maintaining any treatment, so the individuals will go back to their old habits of finding drugs from unsafe sources.
The problem of limited access to treatment affects more than just the abuser alone. The consequence of this can leave a family struggling financially and emotionally from the potential death of a family member. Leaving behind the burden of medical costs, funeral costs, or a now parentless child. If the overdose doesn't lead to death, then a life of health problems and instability will persist. The responsibility of dealing with drug overdoses is dealt with in many areas including hospitals, ambulances, pharmacies, social services, and public safety. With the illegal drug market evolving rapidly, these institutions need to constantly improve their responses to the problem. According to the CDC, for every death from overdose, there are many who suffer from non-fatal overdose, and this take a toll on the community emotionally and economically ("Preventing Opioid Overdose"). If the lack of care to this issue continues, then repeat offenders of overdosing will keep using, adding to the statistic.
On the other hand, these regulations can be detrimental to the individual's health when they become too strict. This hinders access to proper pain treatment for those who are actually suffering from diagnosed health problems. People suffering from cancer and many other diseases cannot be automatically classified as drug attics. Afezolli, Easton, and Ahmed explain how the lack of opioids and some policies have made it nearly impossible for patients who suffer from various illnesses that require pain management prescriptions (Afezolli). However, it does not mean that these policies should not consider regulations because of health diagnoses. There are still precautionary measures that need to be taken. It just goes to show that there cannot be one universal rule because not one policy works in all cases.
Due to abusers sometimes finding themselves facing time in jail, this can lead to a gap in treatment or causing the individual to have terrible withdrawal symptoms. The jail sentence itself does help with forcing an individual to go cold turkey, but it does not solve the opioid use disorder. When released from jail, the tolerance of the individuals has dropped, but the cravings will come back due to the lack of substances. Because it has been some time, when they start back on the same dosing they were doing before, it can result in overdosing and sometimes fatal (Flanagan Balawajder). If there was access to rehabilitation while in jail, this would open the door to sobriety and end the vicious cycle. All correctional facilities should consider drug screenings and either continue or begin medications for those suffering with OUD. In a national survey conducted by Flanagan Balawajder along with other researchers, they found that only 43.8% of U.S. jails provide medication to treat some individuals suffering with opioid use disorder. While only 12.8% made the medications available to individuals that would request the medication (Flanagan Balawajder). The data shows that the main response to OUD is to force individuals to go cold turkey in hopes this will lead to recovery. Although, without medication or any treatment, this will not solve the problem.
While systems do slowly continue to improve, the fastest lifesaving option that can be used right away is naloxone. Naloxone, or Narcan, is a medication that is used to counteract the effects of opioids on the receptors. This medication can save an individual's life when administered as soon as possible to restore breathing while medical attention is in route. (Naumann). The use of naloxone does not give any feelings of euphoria and is not addictive, and many community resources have the ability to distribute Narcan to the public. Educating individuals that not only use opioids, but also family or peers on how to administer narcan can be highly effective. According to the CDC, one of the suggested approaches to increase accessibility to naloxone includes distribution within the community and letting people know where they can find this medication (Public Health Considerations for Strategies and Partnerships). By making naloxone accessible, this turns drug overdosing into a serious medical event and gives opportunity for entering a treatment program.
This method has also been researched by North Carolina State and is examined through the community. The distribution of Narcan and trainings on administration have been given throughout many communities and it was found there was a higher rate of survival from overdosing in the areas that were dispensing more Narcan in comparison to areas that were rarely dispensing. Although these studies cannot directly prove there is a definite cause and effect to the decrease in deaths. It was estimated that this study prevented an estimated 352 deaths by the end of 2016 (Naumann). With that, naloxone becomes an effective and cheap solution to a short-term issue. But it does not solve the problem of addiction leading to overdose. After survival, the individual will need lots of medical attention. Therefore, every instance of a naloxone administration should be considered as a chance to receive help again, not the solving factor (Naumann).
While we all wonder where exactly it could have all went wrong, there should be great consideration that the process of making improvements should have begun in the beginning phases of taking the medications. During the phase of drug promotion and prescribing, there should be mandatory consultation on the many risk factors associated with these medications. Healthcare providers need to be trained in safe prescribing practices and trying alternative pain management options to differentiate between patients. Prescription monitoring doesn't stop at the online programs but should also include discussions and extensive plans for treatment without assuming there is automated medication abuse. The findings of Puac-Polanco reveal that mandatory prescription monitoring could enhance the prescription process, even with the different laws varying from state to state (Puac-Polanco). Effective prescriptions rely on using reliable information and clinical judgment to ensure proper medical care (Afezolli).
Coordinated efforts will allow all these interventions to be brought together into one cohesive plan. Pharmacist intervention is important when identifying drug interactions and referring to treatment programs. Prescribers can then use the monitoring programs to analyze a patient's medical history and concerns with chronic pain. Also, the health department tracks the pattern of overdoses and will use this to decide which areas need more naloxone versus others ("Public Health Considerations for Strategy and Partnerships"). Correctional facilities can give medications and arrange treatment before release, while community organizations can help with transportation and keeping individuals on track. The CDC emphasizes that public health and safety organizations close the gaps in knowledge and other services that can weaken the efforts toward opioid overdose prevention ("Public Health Considerations for Strategy and Partnerships"). It might be argued by some that severe punishment must be given to prevent distribution of opioids. However, these measures can be justified in the case of people producing or distribution the illegal drugs, including fentanyl, the one who suffers from OUD cannot be considered either.
The opioid crisis further developed from a combination of the effects of marketing by pharmaceutical companies, poor prescribing habits, addiction, lack of treatment and an increase in illegal drugs on the street. The progression from prescription opioids to heroin and fentanyl proves that cutting down on prescriptions is not going to solve the problem. Prescription monitoring and responsible prescribing will always be an important factor in treatment; but these practices need to be used in a way that will allow for safe medical practice, not limiting access to medications from patients. Naloxone can save lives right away, while medication therapy and long-term support can prevent future overdoses. Pharmaceutical oversight, insurance coverage, correctional treatment, and cooperation from the community are also important practices. The most important aspect is to make a distinction between people who need treatment or have genuine pain and knowingly selling drugs illegally. The theory that "one size fits all" when considering different treatments is hurting more than it is helping and has been proven to be insufficient. A healthcare-oriented response will be far more effective in decreasing deaths while ensuring the safety of patients and their communities.
Over time, the use of opioids has continued to grow. It has taken over the initiatives used to control it, and we are constantly left to find new solutions to the problem. Opioids have been an ongoing "trend" starting with prescription opioids, leading to a downhill spiral to heroin and illegal drug use, including fentanyl. In 2023, there were roughly 80,000 deaths from overdose out of the 105,000 drug related deaths ("Understanding the Opioid Overdose Epidemic). Even though this statistic is not near the numbers in previous years, it is still 10x higher than in 1999 ("Understanding the Opioid Overdose Epidemic). Using these statistics, it shows that the crisis is the result of more than just lenient prescriptions and illegal drug dealing. Even with an increase in monitoring from healthcare providers, the problem still persists. With effective marketing, more treatment options and extended education on naloxone, fewer lives would be lost, and more people can receive the help they need.
The epidemic began with a belief that these medications would be the most effective and safest way to treat pain. By minimizing the dangers of addiction or dependency, pharmaceutical industries were able to encourage the use of opioids through marketing and sugarcoating. ("Overprescribing Opioids and the Opioid Epidemic"). Because of this, doctors were prescribing in higher doses than needed, and individuals were taking the medications without knowing the potential dependence they were developing. They believed that the prescription given to them by their doctor was safe. The history of the crisis is important to consider because many think it was caused by the patients' behaviors and decisions, but that's not the case. The drug manufacturing companies, regulatory agencies and healthcare providers led to the increased availability of the drugs. Future policies need to take into consideration the spread of misinformation and educating their patients instead of just blaming those that are dependent. (Overprescribing Opioids and the Opioid Epidemic)
According to the CDC, the epidemic of opioid overdoses has been made up of three different waves, all within relation to each other. The first wave seems to have started in the 1990s with an increase in prescription opioids. The result of this was an increase in deaths from the use of these medications. Then around 2010 the next wave began. The abuse of heroin took communities over by storm, and the heroin related deaths continued to climb. Finally, starting in 2013, synthetic opioids and illegally produced fentanyl. Fentanyl has been found in many street dealings, sometimes formed into counterfeit pills or mixed within different drugs unknowingly ("Understanding the Opioid Overdose Epidemic"). The progression of these waves going from prescription opioids to heroin or fentanyl shows the major flaws in only focusing on one opioid at a time. Although it all seems to have started due to the over prescribing of these medications, addressing only that issue does not end addiction or individuals finding these drugs other ways. In many cases, individuals who could no longer obtain a prescription would transition to other alternatives (Kharasch).
With the transition from one to the other becoming more common, there should be consideration for OUD, Opioid Use Disorder, to be seen as a medical condition rather than just criminal behavior. Opioid use disorder changes how a person responds to things like cravings, withdrawals, stress, decision making and risk factors. The worst part is that a person with this disorder may continue using opioids even after causing damage to their health, social life, or finances. Criminal punishment alone cannot help with these ongoing factors; there needs to be options for treatment, medication therapy, counseling or other helpful outlooks ("Preventing Opioid Overdose"). As revealed by Kharasch and his team of coauthors, the current policy shows that the reduction of prescriptions has consequently led to an increase in death from opioids. Kharasch argues that the policy is specifically based on the decrease in the number of prescriptions and doesn't take into consideration the constant change in street dealings and those who are dependent needing help (Kharasch). A public health response is more likely to reduce harm because it would focus on prevention and recovery, instead of waiting for the individual to end up in the criminal justice system.
One of the best resources to come out of the initiatives taken was the Prescription Drug Monitoring Programs or PDMPs. They provide us with information linking controlled substance prescriptions using a statewide database. Physicians can check the patient's prescription history and base therapy from the findings. With this, there can also be information that would reveal malpractice or any suspicious activity from providers. This being duplicate prescriptions, refill requests before acceptable prescribing time, too high of dosing, or prescribing of drugs that could cause overdose (Public Health Considerations for Strategies and Partnerships). Puac-Polanco and other authors reviewed 29 different papers on the information provided from prescription drug monitoring programs. Most studies showed that there were less prescriptions once the program was introduced, but the number of deaths seemed to not change. Only 4 out of 8 studies showed a decrease in opioid-related deaths (Puac-Polanco). This mixed result does not mean that drug monitoring programs are useless, but more about how providers should use this information to connect patients for safer pain management or addiction treatment when presented with the warning signs. Not just strictly based on the programs.
The current fentanyl epidemic makes the use of warning signs and using resources even more important. Prescription Drug Monitoring Programs can track medications given to patients through a healthcare provider, but it cannot identify a counterfeit pill purchased illegally or what other substances could be mixed within them. According to the CDC, illegally produced fentanyl has become so popular within the black market and is often created to mimic legitimate prescription drugs (Understanding the Opioid Overdose Epidemic"). Because of this, people purchasing these pills in hopes of taking oxycodone, for example, end up consuming fentanyl-based tablets which could contain an unpredictable and potentially life-threatening amount of fentanyl. At the same time, the individuals who want to seek help might face many obstacles, prior authorizations, limitations from insurance, lack of healthcare, or even being stereotyped by healthcare providers (U.S. Government Accountability Office). The repercussions of the obstacles lead to difficulty in starting and maintaining any treatment, so the individuals will go back to their old habits of finding drugs from unsafe sources.
The problem of limited access to treatment affects more than just the abuser alone. The consequence of this can leave a family struggling financially and emotionally from the potential death of a family member. Leaving behind the burden of medical costs, funeral costs, or a now parentless child. If the overdose doesn't lead to death, then a life of health problems and instability will persist. The responsibility of dealing with drug overdoses is dealt with in many areas including hospitals, ambulances, pharmacies, social services, and public safety. With the illegal drug market evolving rapidly, these institutions need to constantly improve their responses to the problem. According to the CDC, for every death from overdose, there are many who suffer from non-fatal overdose, and this take a toll on the community emotionally and economically ("Preventing Opioid Overdose"). If the lack of care to this issue continues, then repeat offenders of overdosing will keep using, adding to the statistic.
On the other hand, these regulations can be detrimental to the individual's health when they become too strict. This hinders access to proper pain treatment for those who are actually suffering from diagnosed health problems. People suffering from cancer and many other diseases cannot be automatically classified as drug attics. Afezolli, Easton, and Ahmed explain how the lack of opioids and some policies have made it nearly impossible for patients who suffer from various illnesses that require pain management prescriptions (Afezolli). However, it does not mean that these policies should not consider regulations because of health diagnoses. There are still precautionary measures that need to be taken. It just goes to show that there cannot be one universal rule because not one policy works in all cases.
Due to abusers sometimes finding themselves facing time in jail, this can lead to a gap in treatment or causing the individual to have terrible withdrawal symptoms. The jail sentence itself does help with forcing an individual to go cold turkey, but it does not solve the opioid use disorder. When released from jail, the tolerance of the individuals has dropped, but the cravings will come back due to the lack of substances. Because it has been some time, when they start back on the same dosing they were doing before, it can result in overdosing and sometimes fatal (Flanagan Balawajder). If there was access to rehabilitation while in jail, this would open the door to sobriety and end the vicious cycle. All correctional facilities should consider drug screenings and either continue or begin medications for those suffering with OUD. In a national survey conducted by Flanagan Balawajder along with other researchers, they found that only 43.8% of U.S. jails provide medication to treat some individuals suffering with opioid use disorder. While only 12.8% made the medications available to individuals that would request the medication (Flanagan Balawajder). The data shows that the main response to OUD is to force individuals to go cold turkey in hopes this will lead to recovery. Although, without medication or any treatment, this will not solve the problem.
While systems do slowly continue to improve, the fastest lifesaving option that can be used right away is naloxone. Naloxone, or Narcan, is a medication that is used to counteract the effects of opioids on the receptors. This medication can save an individual's life when administered as soon as possible to restore breathing while medical attention is in route. (Naumann). The use of naloxone does not give any feelings of euphoria and is not addictive, and many community resources have the ability to distribute Narcan to the public. Educating individuals that not only use opioids, but also family or peers on how to administer narcan can be highly effective. According to the CDC, one of the suggested approaches to increase accessibility to naloxone includes distribution within the community and letting people know where they can find this medication (Public Health Considerations for Strategies and Partnerships). By making naloxone accessible, this turns drug overdosing into a serious medical event and gives opportunity for entering a treatment program.
This method has also been researched by North Carolina State and is examined through the community. The distribution of Narcan and trainings on administration have been given throughout many communities and it was found there was a higher rate of survival from overdosing in the areas that were dispensing more Narcan in comparison to areas that were rarely dispensing. Although these studies cannot directly prove there is a definite cause and effect to the decrease in deaths. It was estimated that this study prevented an estimated 352 deaths by the end of 2016 (Naumann). With that, naloxone becomes an effective and cheap solution to a short-term issue. But it does not solve the problem of addiction leading to overdose. After survival, the individual will need lots of medical attention. Therefore, every instance of a naloxone administration should be considered as a chance to receive help again, not the solving factor (Naumann).
While we all wonder where exactly it could have all went wrong, there should be great consideration that the process of making improvements should have begun in the beginning phases of taking the medications. During the phase of drug promotion and prescribing, there should be mandatory consultation on the many risk factors associated with these medications. Healthcare providers need to be trained in safe prescribing practices and trying alternative pain management options to differentiate between patients. Prescription monitoring doesn't stop at the online programs but should also include discussions and extensive plans for treatment without assuming there is automated medication abuse. The findings of Puac-Polanco reveal that mandatory prescription monitoring could enhance the prescription process, even with the different laws varying from state to state (Puac-Polanco). Effective prescriptions rely on using reliable information and clinical judgment to ensure proper medical care (Afezolli).
Coordinated efforts will allow all these interventions to be brought together into one cohesive plan. Pharmacist intervention is important when identifying drug interactions and referring to treatment programs. Prescribers can then use the monitoring programs to analyze a patient's medical history and concerns with chronic pain. Also, the health department tracks the pattern of overdoses and will use this to decide which areas need more naloxone versus others ("Public Health Considerations for Strategy and Partnerships"). Correctional facilities can give medications and arrange treatment before release, while community organizations can help with transportation and keeping individuals on track. The CDC emphasizes that public health and safety organizations close the gaps in knowledge and other services that can weaken the efforts toward opioid overdose prevention ("Public Health Considerations for Strategy and Partnerships"). It might be argued by some that severe punishment must be given to prevent distribution of opioids. However, these measures can be justified in the case of people producing or distribution the illegal drugs, including fentanyl, the one who suffers from OUD cannot be considered either.
The opioid crisis further developed from a combination of the effects of marketing by pharmaceutical companies, poor prescribing habits, addiction, lack of treatment and an increase in illegal drugs on the street. The progression from prescription opioids to heroin and fentanyl proves that cutting down on prescriptions is not going to solve the problem. Prescription monitoring and responsible prescribing will always be an important factor in treatment; but these practices need to be used in a way that will allow for safe medical practice, not limiting access to medications from patients. Naloxone can save lives right away, while medication therapy and long-term support can prevent future overdoses. Pharmaceutical oversight, insurance coverage, correctional treatment, and cooperation from the community are also important practices. The most important aspect is to make a distinction between people who need treatment or have genuine pain and knowingly selling drugs illegally. The theory that "one size fits all" when considering different treatments is hurting more than it is helping and has been proven to be insufficient. A healthcare-oriented response will be far more effective in decreasing deaths while ensuring the safety of patients and their communities.
