research report: two views

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Ritter 1 Anaya Ritter Ms. Burns WAC 101; 70279 31 October 2021 Opioid Crisis: Two Views In 2020 alone, over 90,000 people died due to drug overdoses. This created the worst opioid overdose crisis in American history (Vaida 3), which has caused a debate on whether or not regulators have restricted drug access too much. Have regulators done too much to restrict legal access to prescription drugs? Although people hold a range of opinions about how to answer this question, a significant number argue that yes, regulators have done too much to restrict legal access to prescription drugs because individuals with chronic pain have a harder time obtaining opioids, patient advocates say insurers have used CDC guidelines to deny reimbursement and doctors are turning patients away saying the patients in pain are being forced into opioid withdrawal, causing extreme pain, in some cases, driving them to suicide, and a significant number argue no, regulators have not done too much to restrict prescription drug access because clinic doctors would make a cursory eval and send patients to an onsite pharmacy where they could buy narcotics, and the patients took them home and sold them to neighbors, some experts defend all the regulations as necessary, noting that prescription drug abuse remains widespread and the US is prescribing more than any other country on Earth. The first reason why regulators have done too much to restrict legal access to prescription drugs is because individuals with chronic pain have a harder time obtaining opioids. Independent journalist, Bara Vaida states that, “More than 20 percent of Americans said they experienced chronic pain in 2019, and about 7.4 percent said it was severe enough to impede their quality of

Ritter 2 life, according to the CDC. But those with severe chronic pain are finding it increasingly difficult to obtain opioids” (Vaida 6). This is significant because certain guidelines that have been put in place are making it extremely difficult for people to have quality of life instead of being stuck in pain everyday. Vaida informs that, “A 2016 guidance from the Centers for Disease Control and Prevention is making it harder for patients to acquire opioids, some health experts say (Vaida 6). States have carried out a number of measures to speak on the opioid epidemic. One way they have done this is by creating pill mills. Pill mills are doctors’ offices, pain clinics and other providers that dispense large amount of prescription drugs for nonmedical reasons. In doing so, this makes it harder for people with chronic pain to acquire the opioids they need. The second reason why regulators have done too much to restrict legal access to prescription drugs is because patient advocates say insurers have used CDC guidelines to deny reimbursement. In the article, “A Crisis of Opioids and the Limits of Prescription Control”, Dr. Stefan G. Kertesz, professor of preventive medicine at the University of Alabama, Birmingham, says, “Coming from a range of agencies, encompassing professional boards, public and private payers, law enforcement and more, they reflected a re-calibration of policy compared to the prior decade, when powerful commercial, regulatory and legal initiatives embraced opioids as a cardinal, under-appreciated asset for treatment of pain” (Kertesz 1). This quote is explaining how different powers are trying to come together to try and figure out what the best way to go about this crisis is, thus, ensuring the safety and effectiveness for all parties. Kertesz informs that, “We will suggest that US policy reflects an imbalance that threatens efforts to address pain and addiction, while endangering patients whose receipt of opioids for pain represents a key part of their care” (Kertesz 1). With said policy in place, patients with chronic pain have a hard time

Ritter 3 getting opioids to treat them. As stated previously, correcting this US policy can rewrite this imbalance. The third reason why regulators have done too much to restrict legal access to prescription drugs is because doctors are turning patients away saying that the patients in pain are being forced into withdrawal, causing extreme pain, in some cases, driving them to suicide. Emeritus Professor, Wayne D. Hall explains, “A failure to expand effective treatment will ensure that opioid overdose deaths in the US continue to increase” (Hall 2). Because these doctors will not treat said patients, the number of sicknesses/deaths will continue to skyrocket. With the rising overdoses in the US, many people will continue to illegally obtain and consume opioids for their benefit. Hall states, “The risk of dying accumulates with repeated cycles of incarceration and release” (Hall 1). We see repeat offenders of opioids return to their old ways when coming out of prison. When caught, they return to prison with no support. Some believe that receiving treatment while in prison can help reduce the rate of drug overdoses. A lot of people tend to disregard the severity of what they are doing. Many see going to jail as something that sets them back, so when they get out, they go straight back to their previous ways. However, there are many who have the opposite viewpoint. There is an opposing stand on this topic because many think regulators have not done enough to restrict access to prescription drugs. They have some reasons as to why they hold this point. The first reason as to why regulators have not done enough to restrict legal access to prescription drugs is because clinic doctors would make a cursory evaluation and send patients to an onsite pharmacy where they could buy narcotics, and the patients would take them home and sell them to the neighbors. Vaida says, “People brought them home to sell to neighbors, spreading the opioid epidemic in communities” (Vaida 7). When people started to realize that

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Ritter 4 they could make a certain amount of money on a single pill, it became a strategy to add to their income. They did not care about the consequences. They just wanted to make extra money. Joe Eaton, professor at the University of Montana School of Journalism states, “People, especially in rural communities, they don’t see anything wrong with selling or sharing prescription medications” (Walsh qtd. in Eaton 3). Because prosecutors mainly focus on the larger scale of opioid pushing, the neighborhood sellers can easily be overlooked and swept under the rug. Because of this, selling in neighborhoods has become way more widespread. The second reason why regulators have not done enough to restrict legal access to prescription drugs is because some experts defend all the regulations as necessary, noting that prescription drug abuse remains widespread. NIDA is the National Institute on Drug Abuse. They state that, “The misuse of and addiction to opioids—including prescription pain relievers, heroin and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare” (National 1). The abuse of drugs remains in the United States. Misusing drugs can alter the brain’s normal patterns and have long-term effects. NIDA explains that, “Misuse of prescription drugs is highest among young adults ages 18 to 25, with 14.4 percent reporting nonmedical use in the past year” (NIDA 1). Many people sell opioids to teens because they know that they will do anything to get what they want. A lot of young teens and adolescents are very impressionable, and some might see their friend doing drugs and want to try. This will increase the percentage of drugs given out by dealers. The third reason why regulators have not done enough to restrict legal access to prescription drugs is because the US is prescribing more than any other country in the world. Co- founder of Physicians for Responsible Opioid Prescribing and medical director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, Andrew

Ritter 5 Kolodny informs that, “We are still prescribing more than any other country on Earth. Far too many people are becoming newly addicted” (Kolodny qtd. in Vaida 8). “Within 30 days of discharge, nearly half of all surgical patients in the United States received opioids in excess of 200 morphine milligram equivalents (MME)” (Patients 1). Prescribing opioids after someone has had surgery is extremely common. This leads to people getting addicted faster because they are being prescribed and taking large doses of prescriptions. With this, overprescribing these opioids has become more widespread. This can increase the risk of long-term opioid use and developing an opioid use disorder. In the article, “Prescription Drug Spending Why Is the U.S. an Outlier?” states, “Compared with other high-income countries, the United States spends the most per capita on prescription drugs” (Prescription 1). The price of drugs that are sold in the United States is substantially higher than that of other countries. Because the U.S. has the largest uninsured population and cost-sharing requirements for the insured are higher than in other countries, U.S. consumers face particularly high costs. In part, these price differences explain current and historical disparities in pharmaceutical drug spending. The outcome of this is important because peoples’ lives could be at risk if nothing is done or if things are done too much. Have regulators done too much to restrict legal access to prescription drugs by not making it easier for individuals with chronic pain to obtain opioids, denying reimbursement and forcing people into opioid withdrawal? Have they not done enough by having doctors send patients to onsite pharmacies and sweeping neighborhood sellers under the rug? Some say yes, they have. Others say, no, they have not. Nevertheless, the opioid crisis is still widespread across the United States.

Ritter 6 Works Cited Eaton, Joe. “Selling Prescription Medications, Opioids Illegally.” AARP , 18 May 2017, https://www.aarp.org/health/drugs-supplements/info-2017/selling-prescription- medications-opioids.html. Hall, Wayne D., and Michael Farrell. "Reducing the opioid overdose death toll in North America." PLoS Medicine , vol. 15, no. 7, 31 July 2018, p. e1002626. Gale In Context: Opposing Viewpoints , link.gale.com/apps/doc/A548630057/OVIC? u=asuniv&sid=bookmark-OVIC&xid=9013bf49. Accessed 9 Oct. 2021. Kertesz, Stefan G., and Adam J. Gordon. “A Crisis of Opioids and the Limits of Prescription Control: United States.” Addiction , vol. 114, no. 1, Jan. 2019, pp. 169–180. EBSCOhost , doi:10.1111/add.14394. National Institute on Drug Abuse. “Opioid Overdose Crisis.” National Institute on Drug Abuse , 1 July 2021, https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis. NIDA. "What is the scope of prescription drug misuse?." National Institute on Drug Abuse, 13 Apr. 2021, https://www.drugabuse.gov/publications/research-reports/misuse-prescription- drugs/what-scope-prescription-drug-misuse Accessed 20 Oct. 2021. “Patients in the U.S. and Canada Are Seven Times as Likely as Those in Sweden to Receive Opioids after Surgery.” Penn Medicine , https://www.pennmedicine.org/news/news- releases/2019/september/patients-in-the-us-and-canada-are-seven-times-as-likely-as- sweden-to-receive-opioids--surgery. “Prescription Drug Spending Why Is the U.S. an Outlier?” Prescription Drug Spending: Why Is the U.S. an Outlier? ,

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Ritter 7 https://www.commonwealthfund.org/publications/issue-briefs/2017/oct/paying- prescription-drugs-around-world-why-us-outlier. Vaida, Bara. "Opioid Crisis." CQ Researcher, 6 Aug. 2021, pp. 1-58, library.cqpress.com/cqresearcher/cqresrre2021080600 .

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