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Topic: Opioids facts, addiction, and overdose.
General purpose: To inform and persuade.
Specific Purpose: To inform my audience on Opioid overdose and addiction, and persuade them
Thesis: The misuse of prescription opioids is a serious problem in the United States of America because an overdose of opioid drugs can cause many health-related problems and deaths.
- Attention-getting device: According to the US Department of Health and Human Services “During 2017, there were more than 72,000 overdose deaths occurred in the United States, including 49,068 that involved an Opioid” It is difficult for researchers to say exactly how many people in the US are dependent however around 20 to 40 million people currently abuse opiates among them many are college going students. This is a serious issue and it starts with a simple prescription.
Back in India, we used to live in apartments, we all kids used to pay together. But after some time, everyone got busy with their family, career etc. However, we still are in contact! We have a What’s app group, where we chat, laugh and discuss many things. Suddenly we got a message from our good friend that “Hari” died!!! It was very shocking but the reason behind his death was more painful as he died by drug overdose. After an investigation, we came to know that 5 years back he had an accident and Doctor prescribed narcotics to relieve pain. After some time he got addicted, he started paying money to doctors, to get this medicine. Then he started to combine these narcotics with his sleep medicine, and finally due to overdose he died.
- The relevance of the topic to the audience: Physician and pharmacist play important role in identifying and preventing non-medical use of prescription drugs. Setting a goal by primary care doctors to stop overprescribing opioid drugs to their patient will be the first step to overcome the problem of opioid addiction.
- Establish credibility: In the medicinal field. due political and pharmaceutical pressure Opioid overdose is neglected topic, there are few laws which are not very strict and many patients are losing their lives, I want to create awareness This is why I chose to represent and research this topic.
- Thesis: Shining the light on the serious problem associated with overprescribed opioids will help physicians to see a realistic and better picture of the dark side of it.
- Preview: These are the main topics to be covered to provide more adequate reasoning to prove overprescribing opioids is detrimental.
- A short introduction of opioids and its mechanism of action.
- Serious side effects of opioid addiction.
- What doctors can do to overcome this problem
- Discuss alternative treatment to avoid prescribing opioids.
(transition: First, I will discuss the importance of understanding what are opioid, few drugs under this class and side effects associated with it)
- Opioids are a class of drugs which is legal to prescribe as a painkiller but illegally sold as heroin.
- As opioids can produce euphoria people can easily get addicted to this drug. This addiction leads to misuse, abuse and lastly due to overdose people can lose their life. Example of opioid painkillers is morphine, methadone, hydrocodone, and oxycodone.
- According to the article Opioid abuse and dependence: Treatment review and future option ( 2010, p.285) explains how Opioid analgesics offer more than just relief from physical and psychological pain; they can also relieve stress, negative emotional states, insomnia, induce euphoria or sense of well-being, and potentiate dependence.
i) Consumption of these drugs comes with many dangerous side effects which are divided into three categories.
(1) Short time side- effects: This includes constant fluctuation in body temperature, mood swings, yawning, drowsiness, constipation etc.
(2) Painful withdrawal symptoms: This includes muscle aches, excessive sweating, trouble sleeping, anxiety, abdominal cramps, blurred vision.
(3) As patient’s tolerance level increases, they become prone to a drug overdose. Long term side effects are hypoxia, short or long time psychological and neurological effects, hyperalgesia, decreased libido, depression, decreased levels of testosterone, and other hormonal effects also are observed.
(transition: Understanding the roots of the problem associated with opioids is very important which will guide doctors, patients and pharmacist to find the solution, however mainly it is doctors responsibility to work on it in many ways)
- According to the Article The opioid prescribing conundrum (2016, P. 20)
“The opioid addiction endemic in this country has skyrocketed with the U.S Center for Disease Control and Prevention reporting that opioid prescriptions have increased 300 percent since 1999 with no corresponding increase in diagnoses. Addiction has spread to predominantly white communities and laws designed to govern opioid prescribing and addiction treatment have piled up. And more and more, doctors are supporting them”
a) Doctors can help patients by following possible options:
1) Starting with the lowest effective dose, but most of the time it does not happen. I have example recently my cousin had a tooth extraction and Dr. prescribed Vicodin to relieve his pain. As per CDC, he should get 3 days’ supply for acute pain however he got 7 days’ supply. He ends up using Vicodin first day and rest of the medicine he did not use.
2) The easy solution is not an option, I agree opioid is an easy solution for pain but if Doctors consider a combination of a non-opiate option if possible: such as considering the effective use of NSAIDs and other painkillers before prescribing controlled substances will help to reduce opioid overdose.
3) Another step is there should be some medical exam, additional test such as MRI, vital signs, review of patient’s medication history. These all should be considered before prescribing Narcotics.
4) Use of pain management intervention such as physiotherapy, acupuncture, chiropractic manipulation, exercise, stress management counseling will help, yoga all these alternatives will help patients to overcome the pain.
5) According to the article, Traditional Chinese medicine in the treatment of opiate addiction, Traditional Chinese medicines are effective in controlling opiate withdrawal symptoms and preventing opiate relapse. TCM is a combination of acupuncture and Chinese medicine
6) Monitoring office staff: There are possibilities that nurses, a medical assistant might call or write their own prescription, or for their friends. Monitoring staff will help to avoid such a felony.
(Transition: If we all work together, we will able to make our patient’s life better)
C) patients will not suffer from unwanted side effects, such as depression, anxiety, suicidal thoughts. They will able to able to enjoy their healthy life. Suicidal rates will decrease.
Conclusion: While opiates prescription are certainly necessary for particular illness but if we as teamwork together it will eradicate the addiction of prescription all over the world.
1) Tonja M Woods, and Michelle Hilaire. “ Opioid abuse and dependence: treatment review and future options.” Formulary, vol. 45, 2010, p. 284-291. http://www.formularyjournal.com/formulary
2) Boerner Heather. “ The opioid prescribing conundrum.” Physician Leadership Journal, July-Aug. 2016, p. 20-22.
Fleischmann, Amos, and Erez C. Miller. “Online Narratives by Adults With ADHD Who Were Diagnosed in Adulthood.” Learning Disability Quarterly, vol. 36, no. 1, 2013, pp. 47–60. JSTOR, JSTOR, www.jstor.org/stable/24570133.
Chadd. “National Resource Center on ADHD | CHADD.” CHADD – The National Resource on ADHD, 2018, www.chadd.org/about- chadd/national-resource-center.aspx.
Goodman, David W., et al. “Assessment of Physician Practices in Adult Attention-Deficit/Hyperactivity Disorder.” Advances in Pediatrics., U.S. National Library of Medicine, 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3505127/.
“Adult ADHD (Attention Deficit Hyperactive Disorder).” Anxiety and Depression Association of America, ADAA, 2018, adaa.org/understanding- anxiety/related-illnesses/other-related-conditions/adult-adhd.
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