Skip to main content
Top
Published in: Current Pain and Headache Reports 3/2018

01-03-2018 | Other Pain (A Kaye and N Vadivelu, Section Editors)

The Opioid Crisis: a Comprehensive Overview

Authors: Nalini Vadivelu, Alice M. Kai, Vijay Kodumudi, Julie Sramcik, Alan D. Kaye

Published in: Current Pain and Headache Reports | Issue 3/2018

Login to get access

Abstract

Purpose of Review

The opioid crisis most likely is the most profound public health crisis our nation has faced. In 2015 alone, 52,000 people died of drug overdoses, with over 30,000 of those people dying from opioid drugs. A recent community forum led by the Cleveland Clinic contrasted this yearly death rate with the loss of 58,000 American lives in 4 years of the Vietnam War. The present review describes the origins of this opioid epidemic and provides context for our present circumstances.

Recent Findings

Alarmingly, the overwhelming majority of opioid abusers begin their addiction with prescription medications, primarily for chronic pain. Chronic postoperative pain, which occurs in 10–50% of surgical patients, is a major concern in many types of surgery. Nationwide, the medical community has made it a priority to ensure that postsurgical analgesia is sufficient to control pain without increasing non-medically appropriate opioid use.

Summary

The opioid epidemic remains a significant pressing issue and will not resolve easily. Numerous factors, including the inappropriate prescription of opioids, lack of understanding of the potential adverse effects of long-term therapy, opioid misuse, abuse, and dependence, have contributed to the current crisis.
Literature
1.
go back to reference • Rudd RA. Increases in Drug and Opioid-Involved Overdose Deaths—United States, 2010–2015. MMWR Morbidity and Mortality Weekly Report. 2016;65. Death count report of opioid-related overdose deaths. • Rudd RA. Increases in Drug and Opioid-Involved Overdose Deaths—United States, 2010–2015. MMWR Morbidity and Mortality Weekly Report. 2016;65. Death count report of opioid-related overdose deaths.
3.
go back to reference Jones CM. Trends in methadone distribution for pain treatment, methadone diversion, and overdose deaths—United States, 2002–2014. MMWR Morbidity and Mortality Weekly Report. 2016;65. Jones CM. Trends in methadone distribution for pain treatment, methadone diversion, and overdose deaths—United States, 2002–2014. MMWR Morbidity and Mortality Weekly Report. 2016;65.
4.
go back to reference Gladden RM. Fentanyl law enforcement submissions and increases in synthetic opioid–involved overdose deaths—27 states, 2013–2014. MMWR Morbidity and Mortality Weekly Report. 2016;65. Gladden RM. Fentanyl law enforcement submissions and increases in synthetic opioid–involved overdose deaths—27 states, 2013–2014. MMWR Morbidity and Mortality Weekly Report. 2016;65.
5.
go back to reference Peterson AB. Increases in fentanyl-related overdose deaths—Florida and Ohio, 2013–2015. MMWR Morbidity and Mortality Weekly Report. 2016;65. Peterson AB. Increases in fentanyl-related overdose deaths—Florida and Ohio, 2013–2015. MMWR Morbidity and Mortality Weekly Report. 2016;65.
6.
go back to reference Clarke JL, Skoufalos A, Scranton R. The American opioid epidemic: population health implications and potential solutions. Report from the National Stakeholder Panel. Popul Health Manag. 2016;19(S1):S-1–S-10.CrossRef Clarke JL, Skoufalos A, Scranton R. The American opioid epidemic: population health implications and potential solutions. Report from the National Stakeholder Panel. Popul Health Manag. 2016;19(S1):S-1–S-10.CrossRef
10.
go back to reference Meier B. Pain killer: A" wonder" drug's trail of addiction and death: Rodale; 2003. Meier B. Pain killer: A" wonder" drug's trail of addiction and death: Rodale; 2003.
13.
go back to reference Control CfD, Prevention. CDC grand rounds: prescription drug overdoses—a US epidemic. MMWR Morb Mortal Wkly Rep. 2012;61(1):10. Control CfD, Prevention. CDC grand rounds: prescription drug overdoses—a US epidemic. MMWR Morb Mortal Wkly Rep. 2012;61(1):10.
19.
go back to reference Society AP. Principles of analgesic use in the treatment of acute pain and cancer pain: American Pain Society; 1999. Society AP. Principles of analgesic use in the treatment of acute pain and cancer pain: American Pain Society; 1999.
22.
go back to reference • Macintyre P, Huxtable C, Flint S, Dobbin M. Costs and consequences: a review of discharge opioid prescribing for ongoing management of acute pain. Anaesth Intensive Care. 2014;42(5):558–74. The consequences of opioid pain regimens for pain therapy.PubMed • Macintyre P, Huxtable C, Flint S, Dobbin M. Costs and consequences: a review of discharge opioid prescribing for ongoing management of acute pain. Anaesth Intensive Care. 2014;42(5):558–74. The consequences of opioid pain regimens for pain therapy.PubMed
25.
go back to reference Manchikanti L, Singh A. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008;11(2 Suppl):S63–88.PubMed Manchikanti L, Singh A. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008;11(2 Suppl):S63–88.PubMed
30.
go back to reference • Psaty BM, Merrill JO. Addressing the opioid epidemic—opportunities in the postmarketing setting. N Engl J Med. 2017;2017(376):1502–4. A review of the evolvement of the public policy surrounding opioid use and how it has shaped pain management.CrossRef • Psaty BM, Merrill JO. Addressing the opioid epidemic—opportunities in the postmarketing setting. N Engl J Med. 2017;2017(376):1502–4. A review of the evolvement of the public policy surrounding opioid use and how it has shaped pain management.CrossRef
33.
go back to reference Kessler ER, Shah M, Gruschkus KS, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacother J Hum Pharmacol Drug Ther. 2013;33(4):383–91. https://doi.org/10.1002/phar.1223.CrossRef Kessler ER, Shah M, Gruschkus KS, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacother J Hum Pharmacol Drug Ther. 2013;33(4):383–91. https://​doi.​org/​10.​1002/​phar.​1223.CrossRef
36.
go back to reference Ailes EC, Dawson AL, Lind JN, Gilboa SM, Frey MT, Broussard CS, et al. Opioid prescription claims among women of reproductive age—United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 2015;64(2):37–41.PubMedPubMedCentral Ailes EC, Dawson AL, Lind JN, Gilboa SM, Frey MT, Broussard CS, et al. Opioid prescription claims among women of reproductive age—United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 2015;64(2):37–41.PubMedPubMedCentral
Metadata
Title
The Opioid Crisis: a Comprehensive Overview
Authors
Nalini Vadivelu
Alice M. Kai
Vijay Kodumudi
Julie Sramcik
Alan D. Kaye
Publication date
01-03-2018
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 3/2018
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-018-0670-z

Other articles of this Issue 3/2018

Current Pain and Headache Reports 3/2018 Go to the issue

Secondary Headache (M Robbins, Section Editor)

Headache Diagnosis in Children and Adolescents

Other Pain (A Kaye and N Vadivelu, Section Editors)

Pain States, the Opioid Epidemic, and the Role of Radiologists