How Can the United States Stop the Opioid Crisis?

overprescribing is only part of problem

By Jonny Lupsha, Wondrium Staff Writer

In the last 20 years, opioid overdose deaths have spiked in the United States. The problem is multifaceted, with less than 25% of drug abusers getting their supply from doctors. How do we stop the opioid crisis?

Different colorful tablets at white background
The spiraling, out-of-control opioid overdose crisis in the United States over the last 20 years affects all ages, genders, and socio-economic groups. Photo by Anastasia Kamysheva / Shutterstock

The opioid crisis in the United States is a major one. Centers for Disease Control and Prevention (CDC) data shows that nearly 81,000 Americans died of opioid overdoses in 2021 alone, up from 70,000 in 2020. The problem is often reduced to a single image of greedy pharmaceutical companies pushing doctors to prescribe opioids like OxyContin to patients, but the bigger picture is far more complicated.

The Food and Drug Administration (FDA) recently approved over-the-counter sales of Narcan, a drug that immediately reverses the effects of an opioid overdose, in hopes that it will save lives. Is this the only way to curb the problem? In his video series The Skeptic’s Guide to Health, Medicine, and the Media, Dr. Roy Benaroch, Adjunct Assistant Professor of Pediatrics at the Emory University School of Medicine, explains the options that can be taken to overcome the opioid crisis.

What Is Narcan and How Does It Work?

In one episode of the series, Dr. Benaroch opens with an all-too-familiar tale of opioid overdose: a young girl whose parents called 911 because she wasn’t breathing. When paramedics arrived on the scene, they realized she was showing signs of heroin use.

“When paramedics found the girl, they immediately administered a medication called naloxone, sometimes called by its traditional brand name, Narcan,” he said. “That medicine is truly life-saving—It immediately blocks the effects of heroin, and almost all other opioids. So, a victim of an overdose, if not already dead, will start breathing again. Unfortunately, it also immediately plunges the victim into full-blown opioid withdrawal.”

Symptoms of opioid withdrawal include intense body aches, anxiety, irritability, and vomiting. Other common symptoms are diarrhea, increased heart rate, fever, and sweating. Dr. Benaroch even referred to opioid withdrawal as “the flu on steroids.” Most people who are given Narcan will suddenly awake, feeling angry and combative. On the ambulance ride to the hospital, they are often given sedatives to calm them down.

However, with death being the alternative outcome of an overdose, opioid withdrawal is certainly preferable—even if people suffering from it may think otherwise, for several days.

How Can the Opioid Crisis Be Stopped?

“Though reasonable steps to prescribe fewer opioids can help, we know the threat of addiction comes mostly from diversion—that is, opioids used by people other than the prescribed patient,” Dr. Benaroch said. “Tackling that problem can start with prescribing fewer pills, and especially fewer pills to people who won’t need them. We need to empty our medicine cabinets, too, and safely get rid of these pills.”

Additionally, he said, prescription-happy doctors who clearly prescribe outside of the practices of good medical care should be shut down, and it’s vital to treat pain properly. For example, most chronic or long-term pain shouldn’t be treated with opioids. “Pill mills,” or pharmacies that traffic in opioids, should also be stopped.

“We also need to identify and treat the mental illness that commonly contributes to pain, or makes pain very difficult to deal with—things like depression and anxiety disorders and alcoholism, all of which contribute to chronic pain,” Dr. Benaroch said. “These are not conditions best treated with opioids.”

The Skeptic’s Guide to Health, Medicine, and the Media is now available to stream on Wondrium.

Edited by Angela Shoemaker, Wondrium Daily