Are We Aware of the Opioid Crisis? A Data Exploration of Opioid Abuse — Part 3
Hello Readers!
The following articles are going to be a part of a three part series on the opioid crisis in Canada and America. The opioid crisis has been declared a national emergency in both countries — and yet I find that not many people are aware of it as they should be.
Some of the questions I will be exploring are:
- What does overall Canadian and American data and research tell us?
- Presentation of data: can we make a comparison between one province and one state?
- How prevalent are prescription opioids?
- What steps can we take to raise awareness and action against opioid overdose?
Since this will be a length of this piece will be long, I want to dedicate a whole article to each question (grouping 3 and 4 together). I hope that you read the series and it really gets the gears going for you. By the end of each article, if you have any questions regarding anything I have explored, please be sure to reach out and let me know!
Note: Raw data and any coding will be uploaded on my Github page and link will be provided at the end of each article.
To Recap — here is Part One and Part Two
The rate of opioid deaths due to overdose and abuse is alarmingly high. In my last article, I highlighted the seriousness of this crisis. In this article, instead of presenting new data, I would like to go in depth on what all these statistics actually been for the future if these rates stay the same, and how we can become a little more aware and help reduce this crises.
This series of articles does not aim to discredit painkillers that are often needed for chronic pain management. Although, these articles aim to bring into light the power of addiction and how the wrong cocktail of powerful drug could lead to a untimely death and tragedy. Drugs such as fentanyl have become popular to use in a recreational setting, when they should be off the streets and strictly controlled.
How prevalent are prescription opioids?
For the last section of this opioid awareness series, I would like to shed some light on the prevalence of prescription opioids, and how they are one of the leading causes of addiction.
As mentioned in the first article, we are aware that quite often, young children and teenagers first come into contact with opioids through poorly monitored prescription medication. Middle-aged and senior adults experience some of the highest hospitalization and death rates, which is speculated to be accredited to misuse and over prescription of these drugs.
Let us take a look at which age groups are most prescribed these drugs, and which opioids are most prescribed to the population of Canada..
Age Groups Most Prescribed
The Canadian Institute for Health Information (CIHI) gathered demographic and geographical data that highlighted some of the most prescribed drugs and which ages they are being prescribed to, as seen in Table 1. Working with hospitals and healthcare facilities, researchers were able to gather and concatenate the information above. Hundreds of thousands of pills were dispensed in the past five years, with middle aged adults being the most affected.
Table 2 and Figure 1 showcase the average of all pills that were prescribed and dispensed to the different age groups. As the table notes, we see a decline of opioids that are prescribed to young adults — age 15 to 24, while the 25–44 age range stays at a similar range through 2011–2015(yet we are still seeing a steady and small decline). We see the sharpest increase in opioids that are prescribed to individuals aged 45–64. The trend we see from 2011 to 2015 is that the average number of pills has stayed stagnant for the 45–64 demographic.
These numbers correspond to Ontario data from article 2. In that article, we were observing a rise in deaths due to opioids in males and females aged 25–44, also, we see some of the highest death rates in the 45–64 males and females. With the corresponding data on the pills that are dispensed to this age group, we can start to piece the story together.
Top 6 Opioids that Are Prescribed
Figure 2 illustrates the top 6 most popular drugs prescribed. We see that some of the most popular are codeine and oxycodone, drugs that are mostly commonly used after minor surgery (such as wisdom tooth removal). Some of the deadliest ones, fentanyl and morphine are also used at a high frequency, and the drug hydromorphone, which is used in prescription pain medicines to manage moderate pain is rising in popularity.
Note that these are opioid chemicals meaning that prescription pills from different pharmacy brands were using this particular drug. These are just ingredients that are used in different pills.
Moving on, it would be beneficial to see the trend in usage through 2012–2016(years that the data was available). Figure 3 shows a matrix of the trend over time of the average pills that were dispensed for each opioid chemical.
We see that in most deadly opioids — for example fentanyl and morphine, we see a sharp decline in how much are used. However, an interesting trend to note is the rise of Tramadol. For some context, Tramadol is a highly controlled narcotic used in brands such as Ultram and Conzip it is known to be a pain reliever for moderate to severe pain, and can only be obtained through a prescription. It is still known why this chemical is being used more and more even with this highly addictive nature. Perhaps (and this is just a speculation), it is not has potent as chemicals such as fentanyl, further research and study would be necessary to see if this is true.
In summary, the good news is that most of these chemicals show a decrease in usage. Perhaps prescription drugs are more controlled than they were initially, perhaps we need to observe how drugs are being controlled on the streets (which is much harder). It would be interesting to get in touch with social workers, psychologists, and people who work with addiction to get an idea of why deaths may be increasing if amount of chemicals in a prescription drug is decreasing. Regularization and awareness may be the missing factor.
What steps can we take to raise awareness and action against opioid overdose?
Recently, the government of Ontario has made active efforts in order to raise awareness of how dangerous opioid overdose can be. First, Public Health Ontario made sure to target social media sites such Facebook, Instagram and Snapchat with advertisements prompting the importance of carrying Naloxone kits — which are known to decrease the effects of an overdose by working against Fentanyl in the bloodstream. Next, advertisements on TV and Radio stations have started to become more and more prevalent. The problem is that the public is still unable to understand why this is such a crisis. While paramedics have to undergo mandatory training on how to specifically treat an opioid overdose as soon as they arrive on scene, many people who are exposed to recreational drugs have no idea what to do in these situations. The problems arises when they call to 911 is placed too late due to the fast reaction of fentanyl.
The Center for Disease Control, Public Health Canada, and many government organizations have started campaigns to raise awareness of the opioids crisis. The CDC has gone to lengths to reach out to at-risk individuals and ensure that they are getting all the information necessary. For example, people in their 40s and 50s that may need to use opioids to treat their pain often receive additional information of the dangerous of prolonged dependency of painkillers.
One of the most beneficial steps individuals can take is to take care of their mental health. Addiction is known to be co-morbid with illnesses such as depression, anxiety, and bipolar disorder, etc. Physical and mental ailment can lead to dependence on drugs such as fentanyl and oxycodone. If an individual knows that they are at risk due to anxiety disorder, or clinical depressions — it would be beneficial to let their doctor know before undergoing a major procedure or getting prescription opioids.
Conclusion
In conclusion, the opioids crisis is very real and something that people are not taking seriously when it should be a top priority for healthcare organizations in North America. Almost two people die every day due to overdose with the most affected demographic being middle aged to senior adults. The death toll for children and young adults is rising and bright young minds are being taken due to misinformation of what these drugs can do.
I hope that through reading this series, you — the readers, are motivated to raise awareness through social media, word-of-mouth, or campaigning. Reach out to your healthcare provider to ask questions about opioids, and whether you need to be using them for treatment. Ask questions about what you can do for your physical and mental health. Finally, stay safe, and stay informed!
Thank you for reading, and please do reach out via the comments for any more information!
