1. Opioid Addiction in the United States Shelby Pearce

2. Subtopics  What is addiction and how does it affect families of addicts?  Why has their been an increase in opioid addiction and overdoses?  Are preventative actions being put in place to counter opioid addiction?

3. What is addiction and how does it affect families of addicts? ASAM (America Society of Addiction Medicine): Definition of Addiction  ASAM is the American Society of Medicine which consists of a professional society including over 4,000 associates (doctors, physicians, ect) in the addiction medicine field.  This source provides me with background information about what addiction is. It is important to allow readers to know specifically what addiction is in order to go forward with my argument. The article states, that addiction is regarded as the inability to abstain from the substance, unable to control behavior and cravings of opioids, inability to recognize problems with “one’s behavior and within interpersonal relationships,” as well as maladjusted emotional responses. Within the individual fighting addiction, there are multiple changes that occur both cognitively and emotionally, altering the person’s behavior. The source also discuses that with external cues, it triggers the craving of opioids and can increase the frequency of participating in other addictive behaviors.

4. What is addiction and how does it affect families of addicts? David Armstrong: Dope Sick: A Harrowing story of best friends, addiction-and a stealth killer  David Armstrong has worked for multiple news sources as well as written about many problems within the medical industry  This article follows DJ Shanks, an opioid addict who eventually dies from an overdose. It follows how Shanks and friends became addicted and the events leading up to his final “hit” and death. It also describes the emotional toll addiction took on Shanks life as well as the aftermath of DJ’s death on his family. The author also discuses the drug Fentanyl, which is a drug that is “100 times more powerful than heroin.” The article states that Fentanyl provides users with the high typically seen with heroin yet, it is produced at a fraction of the cost. It is said that Fentanyl may lead to a catastrophic increase in opioid addiction within the United States in 20 years.

5. What is addiction and how does it affect families of addicts? Michelle Bolyn: The Effects of Heroin Addiction on Families  Michelle Bolyn is a licensed social worker that has been practicing since 2006. She has written many contributing pieces related to mental health.  This source helps me argue the effects opioids, particularly heroin, have on loved ones of the addict. Bolyn discusses that heroin addiction can lead to an increase of stress for family members and cause members to develop mental illnesses. As the need for acquiring more heroin becomes stronger, it negatively affects the families financial situation. For example, the article states, “this (heroin addiction) leads users to spend their life savings, their children’s college funds and any other available money they can get their hands on.” Heroin also affects the addicts long-term life such as the heart or lungs and can lead to a premature death. By losing their family member or friend, people who are close to the addict must suffer from the addiction to opioids just as badly as the addict.

6. What is addiction and how does it affect families of addicts? Substance Abuse and Mental Health Services Administration (US): Impact of Substance Abuse on Families  Substance Abuse and Mental Health Services Administration (US) is a group within the U.S. Department of Health and Human Services that tries to develop peoples understanding behavioral health in the nation.  By using this source I am able to argue the negative affects of substance abuse on families. The article provides readers with a better understanding of what occurs within a family dealing with an opioid addict. The article states, “Children are likely to behave in a manner that is not age ‐ appropriate to compensate for the parental deficiency.” For example, a child of an opioid addict may feel it is necessary to take on the caregiver role in the household due their parents inability. There are multiple behaviors within a substance abuse household: Negativism, parental inconsistency, parental denial, miscarried expression of anger, parental denial, self-medication, unrealistic parental expectations.

7. What is addiction and how does it affect families of addicts? Synthesis “ Definition of Addiction” by the American Society of Addiction Medicine (ASAM) provides me with a clear definition of what addiction is. Addiction is is considered the inability to refuse the drug, loss of control over behavior, problems within personal relationships, and maladjusted behaviors towards situations. By giving a coherent definition, readers will be able to distinguish what I am arguing. “Dope Sick: A Harrowing story of best friends, addiction-and a stealth killer” by David Armstrong gives a real life personal example of the effects opioid addiction has on families and the individual addicted. For example, after Shanks’ death, his friend and the person who supplied Shanks with Fetanyl, Justin Laycock, became extremely depressed and family and friends believed he would end his life soon after Shanks’ death. “The Effects of Heroin Addiction on Families” by Michelle Bolyn also allows me to argue the negative effects opioid addiction has on families. Addiction to opioids leads to increase stress and development of mental disorders, unstable financial means, and can lead to long-term negative affects on the addict’s health. “Impact of Substance Abuse on Families” by the Substance Abuse and Mental Health Services Administration, continues to help me argue about the negative consequences substance abuse has on families. The article explores the negative effects on children such as, the need to play the parental role within a household and explores the common behaviors within a substance abuse household. Each source allows me to portray what addiction really is and how opioid addiction can harm love ones.

8. Why has their been an increase in opioid addiction? CDC (Center Disease Control and Prevention): Injury Prevention and Control: Opioid Abuse  The CDC is a credible government run organization that attempts to educate and prevent diseases using well established data.  The article contributes to my argument by providing background information about the increase in opioid addiction over the years. For example, opioids were involved in 28,647 deaths in 2014 and the amount of overdoses per year has quadrupled since 2000. Studies conducted by the CDC also found that Virginia has risen 14.7 percent in opioid deaths between 2013 and 2014. It also provides information of the four categories of opioids: natural opioid analgesics, semi-synthetic opioid analgesics, Methadone, synthetic opioid analgesics, and heroin. Natural analgesics include morphine and codeine, semi-synthetic include oxycodone, methadone is a synthetic opioid, synthetic analgesics include fentanyl, and heroin, which is a synthesized version of morphine.

9. Why has their been an increase in opioid addiction? ASAM (America Society of Addiction Medicine): Opioid Addiction 2016 Facts and Figures  ASAM (American Society of Addiction Medicine) professional society including over 4,000 associates (doctors, physicians, ect) in the addiction medicine field.  This background source provides statistics for the increase in opioid addiction over the years. ASAM states, “Prescription pain reliever overdose deaths among women increased more than 400% from 1999 to 2010, compared to 237% among men.” It also classifies what an opioid is which helps better explain what is the cause for so many deaths and overdoses. Opioids are considered a class of drug that also include illegal drugs (heroin) as well as legal drugs for pain relief such as oxycodone. By providing well based statistics, I’m able to show how there is an epidemic that can effect someone close to you.

10. Why has their been an increase in opioid addiction? Webster LR1,Cochella S, Dasgupta N, Fakata KL, Fine PG, Fishman SM, Grey T, Johnson EM, Lee LK,Passik SD, Peppin J, Porucznik CA, Ray A, Schnoll SH, Stieg RL, Wakeland W. from Lifetree Clinical Research, Salt Lake City, Utah: An analysis of the root causes for opioid-related overdose deaths in the United States.  This is a well-based study with multiple credentialed doctors and people studying the increase in addiction to opioids and in particular, methadone.  Webster’s group provide important argumentative information that provides my paper with the root causes for why addiction has increased over the years. Some of the causes include, “physician error due to knowledge deficits, patient non-adherence to the prescribed medication regimen, unanticipated medical and mental health comorbidities, including substance use disorders, and payer policies that mandate methadone as first-line therapy.” Although one of these factors can lead to addiction, many experts believe opioid addiction is multifactorial and the need for multiple solutions must attempt to rectify these factors. The article also provides an interesting statistic, a study found that Methadone, which is a synthetic opioid, was 5% of opioid prescriptions prescribed, yet, it led to 1/3 of opioid related deaths nationwide.

11. Why has their been an increase in opioid addiction? Synthesis “Injury Prevention and Control: Opioid Abuse” by the Center for Disease Control and Prevention provides my paper with helpful statistics that show their has been as significant increase over the years in opioid addiction, overdoses, and deaths. “Opioid Addiction 2016 Facts and Figures” by ASAM also provides me with statistics to show how opioid addiction is an increasing epidemic and must be addressed. It also discusses what opioids are and discusses illicit and licit drugs that contribute to the epidemic. “An analysis of the root causes for opioid-related overdose deaths in the United States” by Webster L, et al. helps me discuss and argue the reasons for an increase in opioid addiction. The article states that the reason for the increase is due to, “physician error due to knowledge deficits, patient non-adherence to the prescribed medication regimen, unanticipated medical and mental health comorbidities, including substance use disorders, and payer policies that mandate methadone as first-line therapy.” Also, Webster suggests, that the increase is multifactorial and relies on multiple solutions in order to counter the increase in addiction. Both the “Injury Prevention and Control: Opioid Abuse” and “Opioid Addiction 2016 Facts and Figures” articles provide me with background information about the increase in opioid addiction over the years. “An analysis of the root causes for opioid-related overdose deaths in the United States” helps me argue what the real causes for the increase in opioid addiction are.

12. Is the government and other resources trying to take preventative action? Byrne MH; Lander L; Ferris M from the Department of Behavioral Medicine and Psychiatry, West Virginia University: The changing face of opioid addiction: prescription pain pill dependence and treatment.  Each contributor is a prominent member of the Department of Behavioral Medicine and Psychiatry at West Virginia University.  This article helps me argue that there are actions being done in order to help prevent an increase in opioid addiction. For example, the article explores the use of Buprenorphine, a drug that can stabilize and detoxify an overdose caused by opioids. Many hospitals and ambulances carry Buprenorphine in order to quickly treat an overdose. The article also states that there are four different areas in intervention: treatment, education, advocacy, and research. Each area is necessary in order to try and stop an addiction to opioids from getting worse.

13. Is the government and other resources trying to take preventative action? Kathryn L. Hahn, Affiliate Faculty, Oregon State University College of Pharmacy and Pharmacy Manager, Bi-Mart Corp, Springfield, OR: Strategies to Prevent Opioid Misuse, Abuse, and Diversion That May Also Reduce the Associated Costs  Kathryn Hahn is a prominent member within the pharmaceutical world. She is apart of the faculty at Oregon State within the Pharmacy department and the manager of Bi-Mart corporation.  This article helps me argue that there are preventative actions that are taking place in order to stop the increase in addiction. Hahn states, that there are multiple approaches that can be put in place in order to prevent doctor shopping and help educate patients of opioids and the risk associated with them. In order to help stop the increase Hahn states, “Educating providers and patients on these drugs can minimize opioid abuse; current approaches include prescription monitoring programs, preventing prescription/medical errors, checking patient identification at the pharmacy, referral to pain specialists, and the use of abuse-deterrent opioid formulations.” By taking multiple steps, it eliminates the chance for patients to abuse opioids. It also, provides doctors more guidelines to follow in order to prevent over- prescribing.

14. Is the government and other resources trying to take preventative action? Synthesis According to “The changing face of opioid addiction: prescription pain pill dependence and treatment” by Bryne MH, et al. there are preventative measures in play in order to stop the increase in overdose deaths and addiction. Buprenorphine is being used to treat overdose patients and helps detoxify the patients body, this provides a solution to reducing deaths caused by overdoses. The article also discusses the necessary means to intervention. “Strategies to Prevent Opioid Misuse, Abuse, and Diversion That May Also Reduce the Associated Costs” by Kathryn L. Hahn helps me argue preventative measures that could help decrease opioid addiction. Hahn suggests that through education and identification factors, it prevents overprescribing and doctor shopping. She also suggest that with multiple checks in place it can lead to a decrease in opioid addiction due to limitations for both doctor and patient. Both sources help show that there are solutions being put into play in order to stop the increase in addiction.