A vast majority of non-fatal opioid overdose patients continued to receive opiate prescriptions following their overdose experience, with only a small uptick in medication-assisted treatment for addiction.
A recent paper published in JAMA found that these overdose events, often handled by emergency medical workers, do not necessarily get communicated to the physicians responsible for prescribing opioids to their patients, preventing them from acting in their patients’ best interest.
While mortalities from opioid overdoses have reached record-high levels, the incidence of nonfatal overdoses is even higher; the number of nonfatal overdoses is 30 times greater than fatal overdoses, according to a statistic cited in the study.
Regan P. Kelly, president, and CEO of NET Centers, a nonprofit addiction treatment organization, shared the expectation that she and many others have for new overdose patients.
“You hope that the episode was alarming enough to motivate them to follow up,” Kelly told Philadelphia’s The Inquirer Daily News.
The findings from this study, unfortunately, underscore the challenging nature of drug addiction, which can be so debilitating that even sufferers of nearly-fatal overdoses do not seek help.
Using five years of patient data from the Pennsylvania Medicaid system, researchers from the University of Pittsburgh compared the number of opioid prescriptions before and after an overdose event. From a pool of over 6,000 nonfatal overdose patients, researchers found that the number of patients who received opioid prescriptions only dropped about ten percent following an overdose.
Overlooking the Importance of Medication-Assisted Treatment
Furthermore, there was only a 12 percent increase in medication-assisted treatment after a prescription opioid overdose. The paper cited findings from other studies of private insurance data that reflect similarly low rates of addiction treatment and only slight reductions in prescriptions written following overdoses.
“We had hoped to see a greater response,” said lead author Julie M. Donohue in a press release.
It is worth noting that Medicaid enrollees are three times more likely to overdose than patients with private insurance.
In a successful push to address the opioid epidemic, patients who receive emergency medical attention following an overdose must undergo medical intervention immediately; currently, a system for this is not in place. Halting opioid prescriptions following an overdose event is not enough. While most opioid users get their drugs through a prescription, stopping patients’ prescriptions will merely drive them to seek opiates from illicit sources, potentially exposing them to heroin and the rising threat of fatal substitutes like fentanyl.
Medical Marijuana as a Viable Intervention for Opioid Overdose
Based on research from a recent study on mice, medical marijuana may serve as an effective intervention for addiction. In the study, cannabidiol was found to completely block opioid reward mechanisms in the brain, neutralizing any “rewarding” sensation that addicts typically experience when taking opioids. Cannabidiol did not seem to have any addictive or aversive properties of its own, suggesting its safety for use without perpetuating a cycle of addiction.
Furthermore, the analgesic effect of cannabis can replace the necessity of opioids altogether. A study published this month found that a majority of its subjects felt that marijuana alleviated their symptoms of pain, leading 81 percent of them to reduce their opioid use.
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