Anesthesiology and Clinical Science Research

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Opinion Article - Anesthesiology and Clinical Science Research (2022) Volume 6, Issue 1

Opioid-use disorder and overdose and its risk factors

Benny Alexander*

Department of Anaesthesia and Intensive Care, Rush University, Chicago, USA

*Corresponding Author:
Benny Alexander
Department of Anaesthesia and Intensive Care
Rush University
Chicago, USA
E-mail: [email protected]

Received: 02-Jan-2022, Manuscript No. AAACSR-22-54539; Editor assigned: 04-Jan-2022, PreQC No. AAACSR-22-54539(PQ); Reviewed: 18-Jan-2022, QC No AAACSR-22-54539; Revised: 21-Jan-2022, Manuscript No. AAACSR-22-54539(R); Published: 28-Jan-2022, DOI:10.35841/aaacsr-6.1.103

Citation: Alexander B. Opioid-use disorder and overdose and its risk factors. Anaesthesiol Clin Sci Res. 2022;6(1):103.

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Introduction

Opioid analgesics are now accepted as a valid medical treatment option for patients suffering from severe chronic pain that has failed to respond to other treatments. Opioids, on the other hand, are linked to a number of dangers for both patients and society, including overuse, abuse, and diversion, addiction, and overdose mortality. Candidate selection, assessment before to giving opioid medication and close monitoring throughout the course of treatment are all critical to therapeutic effectiveness. Patient characteristics that may contribute to overuse, abuse, addiction, suicide, and respiratory depression are all considerations that should be considered when assessing and preventing risk. Past or present substance abuse, untreated psychiatric problems, youth, and social or family situations that foster misuse are all risk factors for opioid misuse or addiction. Middle-aged persons with substance abuse and psychiatric comorbidities had a greater risk of dying from opioid overdose. Suicide is a serious issue that should not be overlooked. Suicide is commonly overlooked or misclassified in reporting of opioid poisoning deaths. There is a need to better understand and assess the risks of suicide in those who are in pain. Clinicians can use clinical assessments and an ever-evolving data base to identify patients who have risk factors for opioid side effects. Despite the fact that opioids are an essential and valid means of treating pain, they offer considerable hazards to patients and society, including overuse, abuse, and distraction, addiction, and overdose mortality. In 2015, over 15,000 people died as a result of prescription opioids (excluding non-methadone synthetic opioids like fentanyl and tramadol) [1].

Policymakers responded to the problem by focusing on reducing opioid prescribing, improving regulatory controls, and enacting new legislation across the country focus on reducing opioid prescribing, strengthening regulatory controls, and implementing strict prescribing guidelines. According to the Quintiles IMS Institute, these and other measures appear to have the desired effect of reducing opioid prescriptions, which have declined for the second consecutive year. It decreased by 2.7% in 2015 and 1.7% in 2016. Unfortunately, substance misuse and substance use disorders (SUDs) are incompatible with opioids, and the demands of pain patients are not well fulfilled. Too many pain sufferers lack access to affordable and readily available alternative pain management choices, and federal funding for pain research is progressively dropping. Chronic pain has a variety of effects, but some people suffer from severe pain on a daily basis: According to the 2012 National Health Interview Survey's Functioning and Disability Supplement, 126.1 million US people reported some pain in the previous three months. 25.3 million adults (11.2%) said they were in pain every day, while 23.4 million (10.3%) said they were in "a lot" of discomfort. Those who reported the most pain had a lower health status, used more health-care services, and were disabled the most. A large cohort research of senior pain patients (50 years) found that pain severity, length, and frequency of interference with everyday activities all increase the risk of death.

For chronic pain, multidisciplinary treatment is recommended, and opioids, while not first-line therapy, do help some patients reduce discomfort and regain function. Because of the different criteria and methodologies employed in research, the prevalence of opioid use disorders (OUDs) in individuals treated with therapeutic opioids varies a lot. The number of patients treated with addictive opioids is estimated to be 1 percent to 5% or less in some studies, but this varies greatly depending on the approach and criteria utilised. According to a systematic assessment of 38 studies of individuals with chronic pain treated with opioids, abuse rates ranged from 21% to 29%, with addiction rates ranging from 8% to 13%. Other studies have found that the frequency of OUD in individuals treated with opioids is around 35%, but the link to addiction is unclear. According to the research, more people use opioids for legitimate medical reasons than they do to consume or abuse them. In the event of addiction or addiction-related deaths, however, excessive amounts of prescribed opioids entail substantial health and societal repercussions [2]. This article examines ways for reducing risks and improving therapeutic outcomes with routinely prescribed pain drugs, which include antidepressants, anxiolytics, sleep aids, and other restricted substances in addition to opioids.

Pain assessment

Opioid analgesics are now accepted as a viable medical treatment option for patients suffering from severe chronic pain that has failed to respond to other treatments. Opioids, on the other hand, are linked to a number of dangers for both patients and society, including overuse, abuse, diversion, addiction, and overdose deaths. Proper candidate selection, assessment before to giving opioid medication and close monitoring throughout the course of treatment are all critical to therapeutic effectiveness. Knowledge of patient factors that may contribute to overuse, abuse, addiction, suicide, and respiratory depression is important for risk assessment and prevention. Past or present substance abuse, untreated psychiatric illnesses, younger age, and social or family settings that foster misuse are all risk factors for opioid misuse or addiction. Middle-aged persons with drug abuse and psychiatric comorbidities have a greater rate of opioid death. Suicide is commonly overlooked or misclassified in reporting of opioid poisoning deaths [3].

There is a need to better understand and assess the risks of suicide in those who are in pain. Clinical methods and a growing body of research are available to assist clinicians in identifying individuals who have risk factors for opioid side effects.

Despite the fact that opioids are an essential and valid means of treating pain, they offer considerable hazards to patients and society, including overuse, abuse, distraction, addiction, and overdose mortality. In 2015, over 15,000 people died as a result of prescription opioids (excluding non-methadone synthetic opioids like fentanyl and tramadol). As a result of the crisis, policymakers across the country have focused on lowering opioid prescribing, improving regulatory controls, and enacting strict prescribing guidelines. These and other efforts, according to the Quintiles IMS Institute, appear to be having the desired impact of lowering opioid prescriptions, which are down for the second year in a row. In 2015, it fell by 2.7 percent, while in 2016, it fell by 1.7 percent. Unfortunately, substance misuse and substance use disorders (SUDs) are incompatible with opioids, and the demands of pain patients are not well fulfilled. Too many pain sufferers lack access to affordable and readily available alternative pain management choices, and federal funding for pain research is steadily declining. Chronic pain has a variety of effects, but some people suffer from severe pain on a daily basis: According to the 2012 National Health Interview Survey's Functioning and Disability Supplement, 126.1 million US people reported some pain in the previous three months. 25.3 million adults (11.2 percent) said they were in pain every day, while 23.4 million (10.3 percent) said they were in "a lot" of discomfort. Those who reported the most pain had a lower health status, used more health-care services, and were disabled the most. A large cohort research of senior pain patients (50 years) found that pain severity, length, and frequency of interference with everyday activities all increase the risk of death [2-4].

For chronic pain, comprehensive, multidisciplinary care is best, and opioids, while not first-line therapy, do relieve pain and restore function in some individuals. 8 Because of the different criteria and methods utilised in research, the prevalence statistics of opioid use disorders (OUDs) in individuals treated with therapeutic opioids vary substantially. According to certain research, the number of patients treated with addictive opioids ranges from 1% to 5% or less, depending on the methodology and criteria utilised. According to a systematic evaluation of 38 studies of individuals with chronic pain treated with opioids, abuse rates ranged from 21% to 29%, with addiction rates ranging from 8% to 12%. Other studies have found that the frequency of OUD in individuals treated with opioids is around 35%, but the link to addiction is unclear. According to the research, more people use opioids for legitimate medical reasons than they do to consume or abuse them. In the event of addiction or addictionrelated deaths, however, excessive amounts of prescribed opioids entail substantial health and societal repercussions. This article examines ways for reducing risks and improving therapeutic outcomes with routinely prescribed pain drugs, which include antidepressants, anxiolytics, sleep aids, and other restricted substances in addition to opioids.

Risk factors for misuse, abuse and addiction

Types of medication misuse and abuse occur in patients and non-patients for various reasons that include the following:

•Misunderstanding between the patient and provider.

•Unauthorized self-medication of pain, mood, or sleep problems.

•Desire to avoid symptoms of abstinence syndrome.

•Desire for euphoria or other psychoactive reward.

•Compulsive use due to addiction.

•Illegal diversion for the financial gain.

Before treating chronic pain with opioid therapy, clinicians should assess the patient's risk of OUD and determine the appropriate level of clinical monitoring. Some of the behavioural risk factors that may indicate OUD are:

•Non-functional status due to pain

•Exaggeration of pain

•Unclear etiology for pain

•Young age

•Smoking

•Poor social support

•Personal history of substance abuse

•Family history of substance abuse

•Psychological stress

•Psychological trauma

•Psychological disease

•Psychotropic substance use

•Focus on opioids

•Preadolescent sexual abuse

•History of legal problems

•History of substance-abuse treatment

•Craving for prescription drugs

•Mood swings

•Childhood adversity

Uncontrolled pain stress can also lead to opioid misuse and abuse in patients without other risk factors. In addition, the psychological and emotional distress of childhood or adult trauma, despair in economically depressed communities, the use of binge and thrill-seeking behavior, and the social environment that encourages the use of illegal substances (all of which) [5]. Factors and beyond) can lead to adverse consequences and may contribute to the failure of treatment with opioid therapy.

References

  1. Rudd RA, Seth P, David F et al. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. Morbidity and mortality weekly report. Jama. 2016;65(50 & 51):1445-52.
  2. Indexed at, Google Scholar, Cross Ref

  3. Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012. J Pain. 2015;16(8):769-80. 
  4. Indexed at, Google Scholar, Cross Ref

  5. Minozzi S, Amato L, Davoli M. Development of dependence following treatment with opioid analgesics for pain relief: a systematic review. Addiction. 2013;108(4):688-98.
  6. Indexed at, Google Scholar, Cross Ref

  7. Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005;6(6):432-42.
  8. Indexed at, Google Scholar, Cross Ref

  9. Vowles KE, McEntee ML, Julnes PS et al. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569-76.
  10. Indexed at, Google Scholar, Cross Ref

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