Dr. Rajy Abulhosn, Medical Review Officer at Confirm BioSciences, a drug testing company, says there are several factors that are playing into the rise of the opioid crisis. For example, people are feeling more stressed and isolated, in the coronavirus era, and doctors are unable to medically assess patients through telehealth.
Digital Journal spoke with Dr. Abulhosn about opioids and health options.
Digital Journal: What is the extent of the opioid epidemic in the U.S.?
Dr. Rajy Abulhosn: What we now refer to as the current “opioid crisis” began in the late 1990’s. So for over 20 years we have been battling this issue. Each day about 130 Americans die from an opioid overdose — about 47,000 in total over a year (data is most recent from 2017 and 2018). This crisis isn’t just about someone misusing a medication or overdosing — the opioid crisis has spilled over and impacted public health, mental health, and social and economic health. Between 21% percent and 29 percent of people who are prescribed opioids for chronic pain misuse them, and 8 percent to 12 percent of chronic opioid users will develop opioid use disorder. Opioid has a strong correlation with heroin usage as well – 80 percent of heroin users first misused.
DJ: What are the main impacts on health from taking opioids for too long?
Abulhosn: From a physical and mental health standpoint, the impact is vast and extensive. Chronic opioid use can worsen cardiovascular health (higher risk of heart attacks), respiratory function (higher chance of apnea), gastrointestinal function (constipation, dyspepsia), sexual function (increased risk of sexual dysfunction), neurologic/brain function (higher risk of depression), and musculoskeletal system (higher risk of fractures). Of course, the most significant risk is addiction — and addiction is correlated with a higher incidence of mental health disease, suicide, homelessness, and unemployment.
DJ: How has this worsened during the coronavirus era?
Abulhosn: From recent reports, the opioid related deaths have increased during the COVID-19 pandemic. 35 states in the United States have reported an upswing in overdose deaths related to opioids. Death rate curves which were at least flattening (and in some cases decreasing) are shooting back up again.
DJ: What are the main drivers for this?
Abulhosn: The main drivers for this can be traced to pandemic related disruptions in access to medical care and treatment, as well as the increase in anxiety, loneliness, depression, and feelings of isolation that are connected so closely to addiction and drug usage. Mental Health and drug usage/addiction are connected, and as our collective mental health is impacted (access to care and treatment for mental health has been made more difficult, and more people are experiencing symptoms of mental health illnesses), it will directly affect the other.
DJ: Are pharma companies partly to blame? What can be done in terms of educating citizens about opioids?
Abulhosn: These questions go hand in hand. Pharma companies absolutely share blame in the ongoing opioid crisis. Educating people about the proper use of opioids and dangers of opioids can only come with getting information in front of our patients’ eyes and into their hands. But when pharma companies spend billions of dollars each year on advertising and marketing, it is very difficult for medical providers to overcome that level of information assault. We don’t have the resources to keep up with all the various forms of advertising (print/digital/TV/mail) and direct-to-consumer messaging that come pouring out of these big pharma fountains. The big pharmaceutical companies can exert influence in many ways. Pharma companies pushed their products hard starting in the mid-90’s, downplaying the addiction aspect and promoting its usage for many different types of pain conditions and pain severity. Big pain, little pain, acute pain, chronic pain — “everything was treatable with opioids” was the message they were sending. That being said, the medical community and government oversight bodies need to also accept its role in this as well. Ultimately, the medical providers were the ones writing the prescriptions, and we needed to be more judicious in the utilization of opioids. Guidance should have come earlier from health-related government agencies and national and state medical boards and organizations.
