Opioids are some of the deadliest, most addictive substances on the market today.
While they can be used in moderation to help relieve pain in the short-term, many patients end up abusing opioids and eventually turning to other opioids like heroin, infamous for its grueling addiction, withdrawals, and lethality.
However, prescription opioids can be just as deadly as heroin, even more so in some cases. Some of the most commonly abused prescription opioids today are hydrocodone, oxycodone, codeine, and fentanyl which make up a significant portion of opioid overdoses.
These deadly drugs have long been a problem in Colorado but have gotten significantly worse in recent years, specifically in the southern portions according to new data from the Colorado Consortium on Prescription Drug Abuse.
The Rising Rate of Opioid Abuse in Southern Colorado
The growing problem of opioid addiction in Colorado probably isn’t brand new to most people. The state ranked at about 24th in the country in terms of drug overdose mortality rates which have been rising since the 90s.
However, new figures released by the Colorado Consortium on Prescription Drug Abuse showed that high rates of overdose deaths are particularly concentrated in the southern counties.
While national death rates range from 3.1 in Nebraska to 36 in West Virginia, Colorado’s Pueblo County sees as many as 9.6 deaths per 100,000. Las Animas and Otero counties topped that number during 2015 with 13.5 fatalities per 100,000 people.
Although these numbers aren’t quite as daunting as states in the rustic belt and New England, the statistics show an alarming rate of growth and one that health officials are trying to keep an eye on.
“It’s getting worse,” Mary Steiner of the community Health Partnership told The Colorado Springs Business Journal. “We’re not as bad as Ohio and states back East, who have some 4,000 overdose deaths a year. We’re not there, but one thing we emphasize is the importance of mitigating so we don’t get to that point.”
Opioid Abuse Across the Country
As you may have heard, opioid abuse and dependency isn’t just a Colorado phenomenon. In fact, the entire United States is in the middle of what’s been termed a “national epidemic” by agencies like the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and by the National Institutes of Health (NIH).
Opioid addiction is wreaking havoc on our friends, our children, and even our parents. The CDC reports that in 2015 (the latest data available), an average of 91 Americans died every single day due to an opioid overdose.
A significant number of these overdoses is due to abuse of prescription painkillers like fentanyl and its analogues (which took the lives of over 20,000 people in 2016 alone).
Synthetic opioid deaths in general are on the rise too, increasing by 264% from 2012 to 2015.
Beyond that, heroin abuse is also trending up, with rates of overdose deaths quadrupling since 2010, resulting in the deaths of 12,989 people in 2015.
The drug epidemic has actually gotten so bad that overdoses are now the leading cause of death for individuals under 50 years old. They kill more people per year than both cars and guns, have outpaced peak H.I.V. deaths in 1995, and rise above total U.S. military casualties of the Vietnam War on a yearly basis.
Opioid abuse, then, is a very serious problem that is affecting nearly every person in the nation in one way or another.
Opioids: A Quick Way to Ruin Your Life
Both prescription and street opioids can have a number of detrimental impacts on both your quality and longevity of life.
Some of the short-term effects of opioids like heroin according to NIDA include:
- Dry mouth
- Warm flushing of the skin
- Heavy feeling in the arms and legs
- Nausea and vomiting
- Severe itching
- Clouded mental functioning
- Drifting in and out of consciousness (going “on the nod”)
Long-term effects include:
- Collapsed veins for people who inject the drug
- Damaged tissue inside the nose for people who sniff or snort it
- Infection of the heart lining and valves
- Abscesses (swollen tissue filled with pus)
- Constipation and stomach cramping
- Liver and kidney disease
- Lung complications, including pneumonia
- Mental disorders such as depression and antisocial personality disorder
- Sexual dysfunction for men
- Irregular menstrual cycles for women
Another long-term effect that has been noted by researchers but is still being studied is the impact that opioids can have on the brain’s white matter due to depressed respiration. This condition (known as hypoxia) may result in reduced decision-making abilities, an inability to regulate behavior, and impacted responses to stressful situations.
Besides the immediate threat of overdose (which can be both deadly and easier to do than you think), the lasting effects of opioids like heroin should be reason enough to stay away from these deadly drugs.
How Addictive Are Opioids?
Opioid addiction has become a national epidemic in part because of just how lethal these chemicals can be if they’re abused. But beyond that, another aspect that makes them especially dangerous is the fact that they’re so incredibly addictive.
A report published by the CDC found that a startling number of prescription opioid patients eventually developed substance use disorders involving these drugs. The probability for continued use at one year was 6% and at 3 years it was 2.9%.
Beyond that, individuals given a month-long prescription were at 30% more of a risk of developing a long-term use habit a year later.
It seems clear, then, that even small doses of opioids given for a relatively short amount of time can (and regularly do) result in dependency.
But truthfully, it can actually be quite hard to admit that you have an opioid abuse problem, let alone recognize the signs without any sort of intervention on the part of friends and family.
Part of this is because the brain of an addict becomes fundamentally altered and physically changed to reinforce drug-seeking behavior.
In fact, this understanding of addiction is one of the main reasons substance use disorders are considered to be actual diseases rather than just moral failings like they used to be.
Risk Factors for Developing a Prescription Opioid Addiction
Developing an opioid substance use disorder isn’t reserved for the lower income individual, the Caucasian, or Catholic. Opioid addiction isn’t bound by gender, race, class, religion, or sexuality. It can affect all individuals of all makeups and backgrounds equally.
That being said, there are a number of risk factors that contribute to the likelihood of developing a prescription opioid dependency according to the Colorado Prescription Drug Profile. These include:
- Patients receiving high dosage prescriptions – As you might expect, higher dosages of prescription opioids correlate with higher rates of opioid use disorders and overdoses. In fact, according to the CDC, dosages at or above 50 morphine milligram equivalents (MME) per day increase the risk of overdose twofold compared to 20 MME/day and below.
- Patients with multiple provider episodes (MPEs) – Many times opioid addicts will seek out several different physicians and pharmacies in order to get their hands on more opioids without cluing in their current doctors to their growing addiction.
This practice is often referred to as “doctor shopping” and in 2008 comprised about 0.7% of the opioid-using population. These individuals would average as high as 10 different prescribers in just a 10-month period. What’s more, the number of opioid addiction sufferers has grown substantially, leading some researchers to believe doctor shopping is much more common today.
- Patients prescribed long acting/extended release (LA/ER) opioids who were opioid naïve – New users to opioids (patients who haven’t filled an opioid prescription in 2 months) are particularly vulnerable to developing a dependency problem quicker than other users, especially if they’re prescribed LA/ER opioids. Beyond that, they’re also associated with a higher risk of adverse effects from using these drugs such as respiratory depression and eventual overdose.
- Patient prescription days with overlapping prescriptions – Overlapping prescriptions, whether they be with other opioids or other central nervous system (CNS) depressants like benzodiazepines (Xanax, Klonopin, Valium), can enhance and exacerbate each other’s effects. Overlapping use, then, may result in a higher risk of dependency and even overdose.
The High Impact of Low Prescribing Standards on the Epidemic
One of the main reasons that the opioid epidemic has gotten so out of hand today is the fact that for a long time physicians had very few guidelines that they had to (or bothered to) adhere to when it came to prescribing opioids.
Before the 1980s, physicians generally kept their prescriptions of opioids like Percocet and Vicodin short-term due to the potential for abuse and creating dependency. However, a number of highly-lauded medical papers published in the early 1980s claimed that prescription opioid addiction was in fact quite rare.
What’s more, a shift towards recognizing the importance of pain management made more and more doctors all the more willing to steer clear of the research that proved opioids to be the addictive killers they really were.
When OxyContin came onto the market as a long-term painkiller in 1994, doctors grabbed hold of this “wonder drug” and prescriptions for painkillers jumped by 2 to 3 million each year.
This unfortunate mentality has lingered among many physicians today, leading to the development of the term “problem prescribers.” These doctors may simply not realize the risks for these drugs are so high or they may just not care.
In any case, the CDC has developed guidelines for prescribing opioids for chronic pain in an effort to mitigate any further damage. Now it’s up to the physicians to actually adhere to them.
Painkillers and Heroin
Another major contributor to the gravity of the opioid epidemic today is the fact that prescription painkiller abuse and heroin abuse are intricately connected.
NIDA found that data from 2002 to 2012 showed that the rate of starting heroin was 19 times higher in individuals that reported using nonmedical pain relievers versus those that didn’t. National-level population data also showed that almost four fifths of heroin users had abused prescription opioids before turning to heroin.
Why is the link so strong? The answer may lie in the fact that heroin has actually become cheaper and easier to obtain than many prescription opioids today.
Whether it’s because their prescription ran out, their doctor has refused to re-prescribe, or insurance just won’t keep covering the medication, many patients end up turning to heroin to feed the addiction that prescription opioids caused in the first place.
It’s worth remembering, then, that while the two drugs may seem quite different, they are in fact inextricably linked.
What Can Be & Is Being Done?
Beyond public outreach, community-based educational programs, and stricter prescribing guidelines for physicians, Colorado health officials have begun dealing with the rising opioid epidemic by adopting a harm reduction approach.
This take on addiction recognizes that addiction is in fact a disease and aims to mitigate the damage it can cause. Needle exchange programs are extensions of this view and have popped up all over Colorado as a result of the spreading epidemic.
These facilities significantly reduce the spread of blood borne pathogens amongst intravenous drug users and are some of the most effective ways of curbing diseases that could wreak havoc on a population (as with the 2015 Indiana HIV outbreak).
In fact, according to the North American Syringe Exchange Network, needle exchange programs already exist in eight different Colorado cities today.
Public programs like National Prescription Take-Back Day can also be incredibly effective at reducing the number of old and unused prescriptions that can be stolen, sold, and abused on the streets.
In fact, in 2017 the program collected a whopping 450 Tons of unused prescription drugs and prevented them from falling into the hands of addicts all over the nation.
So, while there is still much work to be done, there are a variety of programs aimed at combating the spread of the epidemic.
Getting Proper Treatment
Taking the first step towards acknowledging your addiction and choosing to get help to treat it can be tough. In fact, the National Survey on Drug Use and Health (NSDUH) conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) for 2009 found that only 11.2% of people who needed treatment for a substance abuse problem actually received proper treatment.
If you can get past recognizing your addiction for what it is, you’re already further down the road to recovery than most.
For opioid dependency, treatment methods vary between facilities. Medication-assisted treatments such as Vivitrol and opioid replacement therapies can be instrumental in ensuring your recovery is a full success.
However, it’s worth remembering that opioid replacement therapies (like buprenorphine and methadone) carry with them a host of their own difficulties as well.
In the end though, you’ll want to find the treatment type that works best for you while still being fully aware that not all programs are equally effective.
Try to find one that features both medication-assisted treatments to help you get through the withdrawals and cravings as well as numerous counselling and therapeutic options as well. These supplementary treatments will help you develop the life skills you need to remain sober once the program has ended.
Opioid Abuse: A Growing Problem for Coloradoans
The opioid epidemic is spreading faster than most people know, especially when it comes to the southern areas of Colorado. And given that this addiction is so incredibly demanding and deadly, it’s imperative that as many people in the state recognize the hazards of these dangerous drugs.
What’s more, knowing what it takes to successfully treat an opioid addiction is information that just may end up coming in handy for you and your loved ones.