America’s Opioid Epidemic and how a Local Pharmacist is Helping Reduce it
Whether you’re a full-time worker, current or former athlete, or living the retired life, consider yourself lucky if you’re living without chronic pain. Attaining painkillers for this constant discomfort can be relatively easy. According to a study published in the April 2014 issue of the journal Medical Care, patients who suggested “Oxycodone” or “Celebrex” during their doctor’s appointment had a 30–40% better chance at getting the prescription. This is a trend that’s persisted for years in America. Over the past two decades, opioids have been alarmingly distributed leading the Centers for Disease Control and Prevention (CDC), to label the opioid problem the “worst drug overdose epidemic in [US] history”.
America’s current opioid pandemic isn’t a foreign problem in our county. The first reports of opioid abuse were during the late 1800s. Women and children would dose themselves to get rid of diarrhea or similar issues, soldiers used them for painful injuries, drinkers took them for hangover relief, and Chinese immigrants smoked opium, a practice that others soon followed.
For the next 25-years, morphine was the drug of choice for both physicians and patients because of its immediate pain relief. The creation of Aspirin and stricter prescription laws were also put into place, and newly trained physicians were able to slowly undercut the opioid epidemic.
Throughout the remainder of the 20th century, prescription opioid addiction surrendered its spot atop the addiction totem pole to nonmedical heroin. Post-WWII in the late 1960s, the inner-city residents were hit hardest by the heroin outbreak; however, after the creation of OxyContin in 1995 medical opioids seized their spot atop the addiction totem pole once again.
According to the CDC, from the mid- ’90s to 2017 prescription opioids have killed almost 218,000 U.S. citizens. That’s enough people to fill the Staples Center in Los Angeles over 10 times! In 2017, 47,000 people died from an opioid overdose which was five times higher than in 1999. Dan Picard, a city councilman in Ohio stated that ambulance fees from an opioid overdose can total $1,100 after the cost of first responders and administering Naloxone. Last year alone, Picard’s city responded to 916 opioid overdose calls. These types of staggering numbers led President Trump to label the opioid epidemic a “public health emergency.”
October 2018, President Trump signed the SUPPORT for Patients and Communities Act. SUPPORT will combat the opioid crisis by increasing awareness and prevention programs, stricter security measures, and will improve treatment during recovery efforts. SUPPORT also provides increased funding towards research to create non-addictive pain pills and will offer non-addictive pain management alternatives.
Until now, the primary alternatives were non-steroidal anti-inflammatory drugs (NSAIDs) and Over-the-Counter (OTC) menthol creams or patches like Bengay or Tiger Balm. These alternatives are appropriate for short-term patients; however, chronic pain suffers are exposed to side effects from NSAIDs like Motrin or Advil after prolonged use. Long-term side effects can be severe such as gastritis, ulcers and increased risk of life threating cardiovascular events like a stroke or heart attack.
Preclinical research on Cannabidiol, otherwise known as CBD, shows the chemical has great promise as a pain reliever. A study done by The Journal of Experimental Medicine suggests CBD can reduce pain and inflammation. CBD alternatives may be able to help opiate users reduce their pain killer intake.
CBD interacts with the body’s naturally occurring endocannabinoid system (ECS) which regulates many of the body’s natural functions like pain, mood, sleep and appetite. CBD can mimic the biological functions of the ECS within the body by interacting with cannabinoid receptors to create and maintain homeostasis within the body.
CBD is the dominant chemical found in the hemp plant and when extracted as an isolate there are no traces of THC. In short, if you use a CBD isolate product you will not experience the “High” sensation because the psychoactive elements of THC are not included in the formula.
The government is proactively trying to find solutions to combat the opioid crisis. Since January 2019, Narcan (Naloxone), the drug commonly used as an opioid overdose antidote, has been available for purchase at local pharmacies.
“These efforts should jumpstart the development of OTC naloxone products to promote wider access to this medicine,” stated Scott Gottlieb, MD, FDA commissioner.
People who use opioids or are living with someone who uses them should keep a form of Naloxone in their home as a precautionary measure. Similar to someone living with asthma, you might not always need your inhaler, but you’ll be happy to have it if you ever do.
States like Ohio and Maryland are in dire need for these OTC versions of Naloxone. According to the National Institute on Drug Abuse (NIH) in 2016, these state’s opioid overdose rate was nearly triple the U.S. average of 13.3 deaths per 100,000. A morgue in Montgomery County, Ohio run by Dr. Kent Harshbarger fills up every night with dead bodies and he believes 60–70% of them are due to an opiate overdose.
“What’s most challenging is seeing the same story repeated over and over again,” he said. “It seems, from my perspective, inevitable.”
The opioid crisis is literally causing bodies to “pile-up” which causes indirect problems to the community. More children being forced into foster care after the loss of one or more parent and the loss of productivity from the deceased citizen negatively affects the economy. There isn’t an overnight fix to the countrywide epidemic, but a Southern California pharmacist created a topical to combat the opiate dependency in her local area.
Initially, the local pharmacist created the pain relieving topical because she was living with chronic back pain. The pain led to rare nights of good sleep and constantly using OTC menthol ointments and lidocaine patches. lastly, she wanted to reduce the amount of painful spine epidurals and oral NSAID’s needed daily.
“I knew something had to change… I had no mobility and the pain never allowed me to relax”, they said. “I was getting epidurals once every three months but that wasn’t enough.”
With her expert knowledge of pharmaceuticals, she combined ingredients that would safely increase her mobility and decrease her levels of pain. She incorporated lidocaine, Menthol and hemp oil CBD isolate after doing extensive research on the plant’s medicinal properties and studies showing benefits for pain and inflammation.
The pharmacist did not create the topical to make a profit, but after she received good feedback from friends and family, she felt obligated to share the product with other pain sufferers looking for less harmful alternatives. She explained, “My main goal is to help chronic opiate users to reduce their intake by 1–2 tablets a day or prevent a non-user from resorting to pain killers.”
“It worked for me, but I was excited and proud to hear it worked for others I care about too,” she said. “I know other people are going through the same struggle because I see them daily.
Working in the pharmaceutical industry gives her an inside view of just how many opioids are consumed a day. According to the CDC, in 2015 (the most recent year for this statistic) 18.7 million prescriptions were made in California alone. That number is under the country’s average consumption rate, but an alternative could reduce that number even more.
Opioids can be highly addictive and can cause liver damage after overuse; however, there is a place in the medical field for opioids. People who have acute pain, like, after surgery or a severe injury, prescription pain killers work fine in the short-term. For long-term patients, finding an alternative to opioids to manage their pain is vital.
Chronic pain can ruin a person’s life because the discomfort is relentless and constantly lingering. It can cause people to miss out on simple things like playing with children or grandchildren, missing recitals because bleacher chairs are uncomfortable, no longer going on hikes because of knee pain, etc. Chronic pain is undeniable, but it doesn’t have to ruin your life. This local pharmacist wants to give people a piece of their life back by offering an alternative.
“My goal is to touch as many lives as possible by them just trying the topical… I want people living with pain to reach for this before a pain pill.”
Written by communication intern at Dr. Yoly’s Pain Relief
References
https://www.cdc.gov/drugoverdose/data/analysis.html
https://www.cdc.gov/drugoverdose/epidemic/index.html
https://pittsburgh.cbslocal.com/2017/05/23/ohio-coroner-space-opioid-deaths/
https://onlinelibrary.wiley.com/doi/full/10.1002/j.1532-2149.2014.496.x
