Combating the Opioid Epidemic through Research and Public Health
Deaths from drug overdoses are at an all-time high in the United States, with opiate abuse – both prescription and illicit – the main cause of these fatalities. Opioids were responsible for more than 30,000 deaths in 2015, representing a quadrupling of opioid-related fatalities since 1999. The concerted efforts of academic researchers, public health officials, and pharmacists are vital to the development of preventative strategies and accessible and effective treatments for opioid abuse disorder. Speakers for Research!America’s webinar "Innovative Research and the Opioid Epidemic: Are We Closer to Finding Solutions?" on October 13, discussed how medical science and public health are addressing these issues.
"We have very effective drugs against pain, but at the same, through the same mechanisms, they are activating highly rewarding areas that can lead and trigger addiction," explained Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA). Opiates are incredibly effective analgesic agents, she continued, but when prescription opioids are taken over time, patients experience drug tolerance, meaning higher doses are required to mediate the same pain-relieving effect. At higher doses, there is greater risk for addiction. This presents a unique problem because many people who develop an opioid abuse disorder were first exposed to the drug in a safe, legal, therapeutic setting: a prescription for pain. Since the incredibly powerful addictive potential of opiates was underestimated by both the pharmaceutical companies that manufacture prescription opiates as well as the clinicians who prescribed them to patients with pain, many patients inadvertently acquired opioid abuse disorder, noted Dr. Georges Benjamin, executive director of the American Public Health Association.
In response to this epidemic, Volkow said the National Institutes of Health (NIH) Opioid Research Initiative has three main areas of focus: non-opioid based strategies for management of pain and pain disorders; new and innovate medications and technologies for opioid addiction treatment; and interventions to reduce the mortality of opioid overdose. Volkow and Benjamin highlighted the importance of facilitating recovery between overdose hospitalizations and treatment, noting that emergency departments and incarceration facilities represent opportunities to start opioid abuse patients on medication-assisted therapy (MAT), which reduces opioid cravings and alleviates opioid withdrawal symptoms. Long-lasting formulations of MATs can provide relief for as long as six months, leading to longer periods of abstinence for patients treated under this program.
Dr. Jeffrey Bratberg, clinical professor at the University of Rhode Island College of Pharmacy, described the role that pharmacists play in combating the opiate abuse. Bratberg described pharmacists as “medication safety specialists” who focus on comprehensive prescription monitoring; substance abuse harm reduction; drug safety education of family, teacher, and clinical providers; and the establishment of best practices for law enforcement and health departments. "Lowest dose, shortest duration," Bratberg added. In terms of education, he said pharmacists are trying to remove barriers to access for at-risk populations that need services and treatment, and the stigma of addiction.
Click here for a recording of the webinar.