Impact of the Opioid Crisis in the U.S.
The opioid crisis has gripped the U.S. since the 1990s when pharmaceutical companies brazenly assured the medical community that patients would not become addicted to prescription opioid pain relievers; today’s reality, however, paints a very different picture.
According to the Center for Disease Control (CDC), in 2018, two out of three drug overdose deaths involved opioids. Moreover, showcased in the 2019 National Survey on Drug Use and Health (NSDUH), “an estimated 10.1 million people aged 12 or older misused opioids in the past year. Specifically, 9.7 million people misused prescription pain relievers, and 745,000 people used heroin.”
More concerning than the addictive properties of prescription opioid pain relievers is that they often act as a gateway to using harder substances, like heroin; “about 80 percent of people who use heroin first misused prescription opioids” (National Institute of Drug Abuse, 2021).
These statistics mentioned above all point to one major underlying issue: overprescription and the following lack of regulation of opioid distribution severely affect civilians of all ages and socio-economic backgrounds. Undoubtedly, the “bigger picture” regarding the opioid crisis is characterized by a few missing links, notably including education.
In the ‘90s, pharmaceutical companies and medical practitioners alike could not account for opioids’ addictive properties - now they can, and yet, the opioid crisis (characterized by overprescription) continues on. Why?
The reality is that opioids come in a variety of flavors, with new ones being added every few years; illicit fentanyl and fentanyl analogs (a synthetic opioid) are currently leading the U.S. drug epidemic. It is crucial to note that the drug overdose epidemic is a multi-layered, complex, socio-economic and political issue.
As previous administrations have attempted to do, the current Biden administration is working diligently to address the opioid crisis that has taken more than 760,000 lives since 1999 (U.S. Department of Health and Human Services, 2021). While robust in nature, the medical community is still making its own recommendations as to how this epidemic should be addressed through a nationwide effort. For example, the American Medical Association (AMA) had this to say about President Joe Biden's Administration’s 2022 National Drug Control Strategy:
Reduce barriers to medications to treat substance use disorders; broaden access to a wide range of harm reduction services, including naloxone, sterile needle and syringe exchange services, and drug checking supplies; require all health insurance programs to remove arbitrary restrictions for care for patients with pain; and take steps to develop and support a national, standardized reporting system for key metrics related to drug use (American Medical Association, July 2021).
Essentially, tighter restrictions on prescription, an expansion of “harm reduction services” and insurance coverage, and more efficient data aggregation methods regarding drug abuse in the U.S. are essential components to combating this epidemic.
Perhaps the most critical aspect of the AMA’s commentary on Biden’s National Drug Control Strategy is the mention of “harm reduction services” - so, what do they entail, and why are they so important?
The Reality of Withdrawal
The length of withdrawal varies depending on the kind of opioid an addict abuses; “heroin and short-acting opioid withdrawal symptoms can typically be seen within the first 8-12 hours after last used, peak within 1-3 days and continue up to 7 days,” while, “long-acting opioids, such as…fentanyl[,] will result in the first withdrawal symptoms appearing up to 36 hours after last use and can continue up to 14 days or more” (American Addiction Centers, 2022).
Regardless of the opioid, withdrawal is best completed under medical supervision. While the symptoms themselves may not be fatal - some of which include nausea and vomiting, insomnia, anxiety, racing heart, muscle and bone pain, and high blood pressure - they can cause severe pain and discomfort. Medically supervised withdrawal can manage, if not eliminate, these symptoms entirely.
It is important to note that the medical treatments for opioid addiction also come in various flavors. One of the more effective treatments, ketamine therapy, has been shown to both alleviate symptoms and help with pain management. Believe it or not, the U.S.’s medical community has relied on clinically administered ketamine since the early 1970s.
Ketamine & Opioid Addiction: Alternative Pain Management
The abuse of an opioid prescription can lead to a chronic illness called hyperalgesia: “an increased sensitivity to feeling pain and an extreme response to pain” (National Cancer Institue, 2022). Those suffering from hyperalgesia could feel increased pain levels, even though their injury has not worsened in condition.
As a noncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist, ketamine works by blocking the NMDA receptors, which are responsible for the amplification of pain signals, the development of central sensitization, and opioid tolerance - to “(suppress) pain transmission by limiting astrocyte and microglial activation” (Bell, Kalso, 2018). In fact, a ketamine for pain management study showcased that ketamine may help reduce and even prevent symptoms of chronic pain; it showcased that “perioperative ketamine decreases postoperative pain scores and opioid requirements” (Bell, Kalso, 2018).
Moreover, in a randomized controlled trial, “NMDA antagonists [like ketamine] were shown to be effective in suppressing the symptoms of opiate withdrawal.” But, how exactly does ketamine interact with our brain, and how can it possibly treat addiction? Although it’s not entirely agreed upon, possible mechanisms by which ketamine may work within addiction include: “[the] enhancement of neuroplasticity and neurogenesis, disruption of relevant functional neural networks, treating depressive symptoms, blocking the reconsolidation of drug-related memories, provoking mystical experiences, and enhancing psychological therapy efficacy” (Romano, Lawn, Krupitsky, Morgan, 2018).
Avesta Ketamine & Wellness Treatment Options
If this blog resonates with you and you suffer from chronic pain, Avesta Ketamine & Wellness is here to help support you in your journey towards holistic wellness. As a fully stacked ketamine infusion clinic - with two locations in Bethesda, Maryland, and McLean, Virginia – and a new location coming to DC this spring, Avesta Ketamine & Wellness specializes in ketamine infusion therapy as a means of treating a multitude of mood disorders: Chronic depression, Treatment-resistant depression, Postpartum depression, Anxiety disorders, Mood disorders, Obsessive-compulsive disorder, and Post-traumatic stress disorder.
As previously mentioned, this same ketamine-assisted psychotherapy can help those suffering from chronic pain caused by migraines, complex regional pain syndrome (CRPS), or fibromyalgia. Keep in mind that while nasal sprays and ketamine pills may help, they are certainly not as reliable as our infusion method, which goes directly into your bloodstream, allowing us to either increase or decrease dosage based on your symptoms.
Why wait to start leading a proactive and more fulfilling life? Contact us today for your free consultation - we can’t wait to help you flourish!
2022—Issue brief Nation’s drug-related overdose and de.pdf. (n.d.). Retrieved March 10, 2022, from https://www.ama-assn.org/system/files/issue-brief-increases-in-opioid-related-overdose.pdf
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Ivan Ezquerra-Romano, I., Lawn, W., Krupitsky, E., & Morgan, C. J. A. (2018). Ketamine for the treatment of addiction: Evidence and potential mechanisms. Neuropharmacology, 142, 72–82. https://doi.org/10.1016/j.neuropharm.2018.01.017
Jovaisa, T., Laurinenas, G., Vosylius, S., Sipylaite, J., Badaras, R., & Ivaskevicius, J. (2006). Effects of ketamine on precipitated opiate withdrawal. Medicina (Kaunas, Lithuania), 42(8), 625–634.
Kelley, R., March 9, N. L. U., & 2022. (n.d.). Opioid Withdrawal: Signs, Symptoms & Addiction Treatment. American Addiction Centers. Retrieved March 10, 2022, from https://americanaddictioncenters.org/withdrawal-timelines-treatments/opiate
Ketamine for pain management. (n.d.). Retrieved March 10, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181464/
Opioid Crisis Statistics | HHS.gov. (n.d.). Retrieved March 10, 2022, from https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis-statistics/index.html
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