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16 - Can We Make Opioid Misuse Less Dangerous?

from Part IV - Recovery

Published online by Cambridge University Press:  07 October 2023

Ethan O. Bryson
Affiliation:
Icahn School of Medicine at Mount Sinai, New York
Christine E. Boxhorn
Affiliation:
Medical College of Wisconsin, Milwaukee
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Summary

Chronic opioid misuse puts people at significant risk for developing multiple health problems, caused either by decreased access to preventative care, exposure to blood-borne or sexually transmitted diseases or as a direct result of chronically elevated levels of exogenous opioids. People with opioid use disorder often suffer from chronic pain and mental illness at rates much higher than in the general population and are at significant risk for financial ruin, homelessness, overdose, and death. While it may not be possible to make opioid use completely safe, if we can, we should make it less dangerous. Illicit opioids are often impure and adulterated after production. They must be procured illegally and are often injected with unsterile equipment in an unsafe and unsupervised environment. All of these factors can and should be addressed as part of a comprehensive strategy to fight the opioid epidemic. Only by challenging the beliefs that underlie the stigma surrounding opioid use disorder and directly addressing the factors that contribute to the increased morbidity and mortality associated with chronic opioid misuse can we turn the tide of the epidemic.

Type
Chapter
Information
The Opioid Epidemic
Origins, Current State and Potential Solutions
, pp. 204 - 217
Publisher: Cambridge University Press
Print publication year: 2023

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References

References and Further Reading

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Guardian (2022). Canada to decriminalize some drugs in British Columbia for three years. Guardian, May 31. www.theguardian.com/world/2022/may/31/canada-decriminalize-drugs-british-columbia-overdoses.Google Scholar
Hiragaki, S, Suzuki, T, Mohamed, AAM, Takeda, M. (2015). Structures and functions of insect arylalkylamine Nacetyltransferase (iaaNAT): A key enzyme for physiological and behavioral switch in arthropods. Frontiers in Physiology 6: 113.Google Scholar
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Oregon State Government (2020). Drug Addiction Treatment and Recovery Act (Measure 110). www.oregon.gov/oha/hsd/amh/pages/measure110.aspx.Google Scholar
Oviedo-Joekes, E, Brissette, S, Marsh, DC, et al. (2009). Diacetylmorphine versus methadone for the treatment of opioid addiction. New England Journal of Medicine 361(8): 777786.Google Scholar
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Strang, J, Teodora Groshkova, T, Metrebian, N. (2012). EMCDDA Insights. New Heroin-Assisted Treatment: Recent Evidence and Current Practices of Supervised Injectable Heroin Treatment in Europe and Beyond. Lisbon: European Monitoring Center for Drugs and Addiction.Google Scholar
Strang, J, Groshkova, T, Uchtenhagen, A, et al. (2015). Heroin on trial: Systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction. British Journal of Psychiatry 207(1): 514.Google Scholar
van Staaden, MJ, Hall, FS, Huber, R. T (2018). The deep evolutionary roots of ‘addiction’. Journal of Mental Health and Clinical Psychology 2(3): 813.Google Scholar

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