1. National Institute on Drug Abuse. (2021, March 03). Opioids. Retrieved March 07, 2021, from https://www.drugabuse.gov/drug-topics/opioids

Background: The National Institute on Drug Abuse summarizes the chemical makeup of opioids and explains how they affect the human body. It lists the different classes of opioids, including illegal substances like heroin and prescription opioids like Oxycontin®. The NIDA warns that even controlled use from a prescription can lead to opioid dependence, abuse, misuse, and addiction. They also mention that, even though it is harder to access opioids, the number of people who overdose on opioids has increased. To combat this, there are drugs that can help treat opioid addiction.

How I Used it: I used this article to explain how opioids create a euphoric feeling, which is what makes them so addictive. I wanted to emphasize that the euphoric feeling is the biggest problem with opioids, and that even a controlled prescription can lead to addiction and overdose. 

2. U.S. opioid Dispensing RATE MAPS. (2020, December 07). Retrieved March 07, 2021, from https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Background: The Centers for Disease Control and Prevention releases maps depicting the distribution of opioid prescriptions in the United States each year. The data shows that, between 2006 and 2012, the number of opioid prescriptions that were dispensed increased to over 255 million people. Since 2012 the distribution of opioids has steadily decreased, but there are some areas of the United States where the number has remained high enough to supply a prescription for each person residing in that area. As of 2019, the total number of prescriptions has decreased to 153 million. Along with the total number of prescriptions, the CDC also creates a graph of the dispensing rate per 100 persons, which showed that 46.7 people per 100 persons are receiving an opioid prescription. They also provide the number and percentage of counties that have available data. In 2019, out of 3,142 counties, there were 3,095 (98.5%) counties with available data on opioid dispensing rates.

How I Used it: Although the rate at which opioids are prescribed in the United States has decreased since 2012, I wanted to provide factual data about how widely available opioids are throughout the United States. I also felt that it was important to point out that the data includes all types of opioid prescriptions, including short-term and long-term. Opioids are commonly prescribed to patients who have recently been released from the hospital to deal with pain post-treatment. By using this article, I wanted to express that there are a few valid reasons as to why opioid availability is still so high in the United States, even during the opioid epidemic.

3. Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services (2016) Guideline for Prescribing Opioids for Chronic Pain, Journal of Pain & Palliative Care Pharmacotherapy, from https://www.tandfonline.com/doi/citedby/10.3109/15360288.2016.1173761?scroll=top&needAccess=true

Background: In 2016, the Centers for Disease Control and Prevention published a new guideline for prescribing opioids to patients with chronic pain. To combat against the opioid epidemic the CDC is recommending that clinical practices make improvements to the means at which opioids are prescribed in order to lessen the number of opioid addictions in chronic pain users. The article goes over when to start or continue prescribing opioids, medication selection, dosage, discontinuation, and risk assessment.

How I Used it: The guideline mentions the use of immediate-release opioids and extended-release/long-acting opioids, which determines the length of time the medication is in effect. I mentioned this in my article to explain how medical researchers have been able to alter opioids in order to provide patients with the prescription that will treat their pain in the way they need it to. I also wanted to show how much research has been done to try and change opioids so that they can still be used in many types of medical situations.

4. Butanis, B. (2018, April 30). What are opioids? Retrieved March 07, 2021, from https://www.hopkinsmedicine.org/opioids/what-are-opioids.html

Background: The Johns Hopkins Medical school gives a synopsis about what opioids are and what they derive from. The article goes over how opioids that are used medically are known as painkillers and that opioids can also be classified as illegal substances, like heroin. It explains how opioids affect the brain and the additional side effects that can occur. The article then goes on to warn about the dangers of prescription opioid use, and encourages people to heavily evaluate their level of risk if they are thinking about asking a doctor for an opioid prescription.

How I Used it: I used this article to define what opioids are and to share that there are more side effects than the one people may think of, like addiction. I wanted to emphasize that taking opioids exposes the body to numerous health risks while increasing the chance of addiction and overdose.

5. Physicians’ opioid prescribing patterns linked to patients’ risk for long-term drug use. (2018, June 22). Retrieved March 27, 2021, from https://www.hsph.harvard.edu/news/press-releases/opioids-addiction-physicians/

Background: A study conducted by Harvard T.H. Chan and Harvard Medical School found that patients who are prescribed opioid medications by doctors that frequently prescribe them are more likely to succumb to opioids for years, even if they were only given one prescription. Long-term opioid use increases the risk of addiction, and this is one of the reasons why the opioid epidemic is still plaguing the United States. The researchers doing the study claim that more solid prescribing practices must be inculcated to ensure that there is similarities in doctor’s prescribing practices.

How I Plan to Use it: I plan to use this article to discuss how prescribing practices should be carefully regulated and that doctors should not be able to get away with practicing medicine so recklessly. I want to emphasize that the opioid epidemic is only going to get worse if doctors in the United States continue to rely on opioid prescriptions. 

6. Kessler, A., Cohen, E., & Grise, K. (2018, March 12). CNN Exclusive: The more opioids doctors prescribe, the more money they make. Retrieved March 27, 2021, from https://www.cnn.com/2018/03/11/health/prescription-opioid-payments-eprise/index.html

Background: Researchers at Harvard University worked with CNN and ran an analysis of doctors that accepted payment from opioid manufacturers during 2014-2015 and the number of opioid prescriptions written for Medicare patients. They found that doctors who prescribe opioids most often are being paid by pharmaceutical companies that make opioids. The data showed that pharmaceutical companies paid 200,000 doctors for prescribing opioids to their patients. Not only that, but doctors who misuse their privilege to prescribe medication like opioids are paid even larger amounts of money. These doctors are receiving seven hundred dollars, or more if they are also providing other services, such as consults and meetings. 

The researchers are unsure if doctors prescribe more in hopes of receiving more money, or if opioid manufacturers find high-prescribing doctors and pay them just for prescribing more. But Dr. Michael Barnett believes that this pattern makes clinicians think that they are creating value with no repercussions. The CNN article also tells about two women who were dealing with opioid addiction found out that their doctors had been accepting money from manufactures who created the thing that destroyed part of their lives. 

How I Plan to Use it: I want to use this article to talk about how disturbing it is that opioid manufacturers will go through large sums of money just to make sure that their product value increases. The doctors are just as responsible for ruining thousands of lives by choosing greed over their promise to care for their patients. In my essay I want to use this to show why the pharmaceutical industry refuses to look into possible alternatives to opioids. They have enough power and money to persuade hundreds of thousands of doctors to prescribe opioids, which is one of the main reasons why opioid use is so overwhelmingly prevalent.

7. University, G. (2019, February 13). Prescription drugs. Retrieved March 28, 2021, from LINK

Background: The Georgetown University Health Policy Institute discusses how prescription drugs are extremely important in modern healthcare, and that people diagnosed with a chronic illness are reliant on prescription drugs in order to function as best they can in their daily lives. Over half of the adult U.S. population is prescribed a drug. The national surveys that gathered data on American adults who use prescription drugs found that prescription drug use and the price of the drug increases with age.

How I Used It: I used this article to show how common it is for people to have a prescription drug. I explained that the pharmaceutical industry benefits off people with chronic illnesses and that they do not wish to find better treatments because the drugs they have now make them a lot of money.

8. Krane, E. J. (2019). The Opioid Debate—PRO. The Clinical Journal of Pain, 35(6), 468–472. doi: 10.1097/AJP.0000000000000700.

Background: The writer claims that opioids are just as beneficial as they are harmful. He briefly goes over the effects the opioid crisis has had on the United States, and explains that the response from citizens was to blame the opioid manufacturers, the prescribers, and the government. The author argues that restricting access to opioids and punishing over-prescribers will not solve the opioid crisis. He explains that there are healthcare workers and people diagnosed with chronic pain who support prescription opioid use, and that opioids are a last-resort option that is guaranteed to work. He discusses the risks, benefits, and the possible alternatives to opioid medication.

How I Used it: I used this source to argue that even though opioids can be beneficial to certain people in certain situations, the damage of the opioid crisis is too severe and the United States can no longer afford to only look at the little picture. Overall, more people end up suffering from opioid use rather than gaining from it. Opioids offer temporary pain at the price of risking addiction and dealing side effects that can cause more pain.

9. Krebs EE, Gravely A, Nugent S, et al. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA. 2018;319(9):872–882. doi:10.1001/jama.2018.0899

Background: This clinical trial was conducted to find out whether opioid painkillers or non-opioid painkillers were more effective in treating back, knee, or hip pain. 240 participants were assessed over a 12 month period to see which group felt more relief and had improved function. The study revealed that the non-opioid group experienced less pain than the opioid group, although there was no significant difference between the two groups in regards to their improvement in pain-related function.

How I Used it: I used this clinical trial to support my claim that opioid treatments help improve people’s pain and function only temporarily. I refuted the opposing claim that opioids are the definitive superior over all other treatment options by discussing the numerous side effects that opioids have that increase pain. 

10. Rieder, T. N. (2018). There’s never just one side to the story: Why America must stop swinging the opioid pendulum. Narrative Inquiry in Bioethics, 8(3), 225-231. doi:http://dx.doi.org.ezproxy.rowan.edu/10.1353/nib.2018.0071

Background: Bioethicist Travis Rieder writes about the pro and anti opioid points of view, and claims that both sides are asking for two different extremes. He believes that if pro-opioid advocates were able to lessen restrictions on opioid prescriptions it would encourage doctors to prescribe carelessly. He also mentions that, at times when opioids were more accessible to the public, that was when the opioid crisis was at its worst. In regards to the anti-opioid argument, Rieder states that under-prescribing is also part of the problem, and that opioid prescriptions are similar to other medications, in the sense that they have damaging side effects but have proven to work extremely well. He believes the recklessness of the doctor’s prescribing opioid medications is what makes opioids so abundant and dangerous.

How I Used it: I used this article to show that I understand that the opioid crisis cannot be solved by simply prohibiting opioid prescriptions, and that doing so would have an opposite effect. People taking opioid prescriptions would not only suffer from their pain, they would also go through withdrawal. This would put many people into dangerous situations by trying to find other methods to ease their pain and withdrawal symptoms.

11. What is an opioid? (2016, May 25). Retrieved from https://archives.drugabuse.gov/blog/post/what-opioid

Background: The NIDA discusses opioid use and how it affects the brain. The summary mentions how 20,000 people die each year from prescription overdose, and suggests that all citizens in the United States should be educated on what opioids are and what they do. The summary also explains the differences between opioid prescriptions and heroin, which is that heroin is injected or snorted so the effects happen quicker and with more intensity.

How I Used it: I used this article to point out that the euphoric “high” people feel while taking opioids is what makes them vulnerable to addiction, and that most pro-opioid arguments tend to ignore the role euphoria plays in opioid treatment. The NAtional Institute on Drug Abuse strongly recommends that opioids should only be taken for as long as they are needed, otherwise, the risk of addiction or dependence will steadily increase.