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The Opioid Crisis of America Is Taking Its Toll

The Opioid Crisis of America Is Taking Its Toll

The United States has a crisis on its hands, and it’s beginning to take its toll. The opioid use in America is not decreasing — on the contrary, overdose deaths are growing in number, and the widespread addiction is creating new epidemics of diseases associated with IV drug use.

But hepatitis C and HIV aren’t the only threats that should have opioid abusers concerned. Bacterial infections caused by using IV drugs are on the rise as well. Each of these diseases can cost tens of thousands of dollars to treat — and the U.S. is underfunded for fighting that. Let’s have a look at why and how the opioid crisis of America became so dangerous.

How the Opioid Crisis Developed

The first opioid addiction crisis occurred as early as the 19th century. After the Civil War in America ended, many soldiers who had been treated on the battlefield found themselves addicted to morphine, which was used as an anesthetic during the war. The addiction was so severe that at first heroin was used to treat it, as it was believed it was not so addictive. In 1924, heroin was officially banned but soon replaced by various other opioids.

Opioids were never classified based on their abuse potential until the 70s and 80s, and even then, mistakes were made classifying Vicodin as less habit-forming than it was. Healthcare professionals promoted narcotics as a safe treatment for chronic pain, which culminated with the release of OxyContin in 1995. Twenty long years later, doctors were finally encouraged by the CDC to cut down on prescribing opioids.

Drug Overdose Deaths and Overall Public Health Crisis

In 2011, the average number of opioid overdose deaths per day was 100. By 2016 that number increased to 115. The majority of all drug overdose deaths in the U.S. are opioid-related — the percentage is at 66.4%. Only in 2016, the opioid crisis claimed more lives than the entire Vietnam War.

It’s clear that the U.S. tends to assess the severity of the opioid crisis by observing total numbers of opioid overdose deaths. However, the overdose deaths aren’t the only parameter that shows how far the crisis has gone. There is also the number of new HIV and hepatitis C cases, as well as other infections caused by using IV drugs. Also, clinics that offer needle exchanges to keep the crisis somewhat under control often fill their large collection boxes in a matter of days. The opioid turmoil is creating a syndemic that needs to be addressed.

The Cost of the Opioid Crisis

Clinics across the country are experiencing a lack of resources to fight drugs as well as the infections they cause. Three common consequences of opioid and drug abuse are HIV, hepatitis C, and bacterial endocarditis. All three are extremely expensive to treat, and, what’s worse — if the patient doesn’t get clean, they will end up in the hospital again.

And the costs are nothing to sneeze at. A case of hepatitis C may cost anywhere from $20,000 to $90,000 to treat. According to the U.S. officials, every patient diagnosed with HIV costs the state around $1 million when all health care and public assistance costs are taken into account. When it comes to bacterial endocarditis, the treatment involves open-heart surgery and can cost between $100,000 to $200,000.

The Rise of Drug Abuse Related Infections

The infections related to drug abuse are on the rise. Reported cases of bacterial endocarditis have nearly doubled between 2002 and 2012, and there are now between 40,000 and 50,000 new cases each year, although it’s unknown how many of those are related to drug abuse. Over the past five years, there was a threefold increase in the cases of hepatitis C. According to the CDC, that’s a 400% increase between 2004 and 2014, and only in Americans aged between 18 and 29. The rise in hepatitis C infection rates has since been connected to the increase of IV drug abuse.

Hepatitis C may be easier to contract than HIV, but that does not lessen the risk of HIV. Outbreaks like the one in 2015 in Indiana when 190 were diagnosed with HIV, frequently happen because of shared needles.

All these infections combined create a syndemic by feeding off each other, fueling the public health crisis further. It is why needle exchanges have become necessary, to dispose of used needles and limit the spread of infections.

The Risks of Drug Abuse Related Infections

Dirty needles aren’t the only cause of infections, although they are the most common. However, it’s not a widely known fact that even using the same needle multiple times is dangerous and can lead to infections. Drug users are often careless and don’t pay much attention to how they mix their drugs, which is another risk factor. There have been reports of using toilet or river water to combine drugs, which is the leading cause of endocarditis as the bacteria from dirty water travels through the user’s bloodstream and eventually builds up in the heart valve.

Other risk factors include not sanitizing skin or needles with rubbing alcohol, sharing needles and using unsanitary equipment to cook drugs. Users who contract these infections usually only end up in the hospital after becoming very sick and many of them are repeat patients, especially when it comes to endocarditis.

Prevention and Cure

Most of the time, hospitals and clinics can only treat the infections caused by drug abuse and not the drug abuse itself. There have been initiatives to offer Suboxone as well as therapy and counseling to patients suffering from drug abuse-related infections so that they wouldn’t end up in the hospital again.

Another way of fighting these infections is the previously mentioned method of opening needle exchanges, which has been proven to help in prevention.

However, most of the burden is of a financial nature: it’s easier to become addicted than get clean in the U.S. There are not enough institutions with the necessary capacities to meet the needs of all people with drug addiction. In those circumstances, clinics can only offer clean needles, wound treatment, and encourage people to seek help.

As it stands, the opioid crisis in America has only just begun, and it will be hard to escape its impact in the coming years. Prevention will be crucial, as well as providing more effective treatment both for the addiction and the problems it causes.

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