# data[].attributes.body
Drugabuse.org presents readers with multiple graphs, depicting overdose rates. These graphs are sorted in multiple different ways. For example, some are overdose rates depending on certain ages and some are overdose rates depending on gender.

# data[].attributes.attachment_link.title
Overdose Death Rates | National Institute on Drug Abuse

# data[].attributes.attachment_link.description
The U.S. government does not track death rates for every drug. However, the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention collects information on deaths involving many of the more commonly used drugs available through 2020 at a searchable database, ca…

# data[].attributes.body
https://wisertogether.com/fighting-opioid-epidemic/This website gives more background on the Opioid Crisis. On top of that, it also provides names of movements anyone could join to help stop others from overdosing. Wisertogether.com really brings attention on to how serious matters already are and are getting.

# data[].attributes.attachment_link.readable_text
Opioid abuse is a dangerous worldwide epidemic that continues to grow. According to the World Drug Report 2017, about 29.5 million people-or 0.6 percent of the global adult population-suffered from drug use disorders in 2015. Opioids were the most harmful drug type during that period, accounting for 70 percent of the negative health impact associated with drug use disorders.

But the epidemic, which has cost healthcare systems millions, has made its deepest inroads in the U.S. More than 115 Americans die daily after overdosing on opioids. Meanwhile, more than 11 million people in the U.S. misused prescription opioids in 2016, says the New England Journal of Medicine.
The U.S. government now considers the opioid crisis a public health emergency.
No Silver Bullet Exists

No silver bullet exists to stop the opioid epidemic. However, health and wellness organizations and government agencies have focused their efforts at awareness and education as part of the solution.

In fact, the National Center on Addiction and Substance Abuse made awareness and education its top recommendation in a guide developed for the federal government on preventing opioid misuse and addiction.

The Center's guide provides the government with a set of concrete actions it can take to make a measurable impact on the epidemic. The Center based these recommendations on years of work in this area and on the work of other organizations with a deep interest in taming the epidemic.

Stemming the Tide of Abuse

To help stem the tide of abuse, WiserTogether added a Key Messaging module to its Return to Health online platform. The capability is a critical enhancement to the healthcare solution. It includes risk warnings on any recommended plan that contains opioids as a treatment option and makes available educational materials about opioid abuse to its users.

WiserTogether's decision to focus Key Messaging's first use of opioids is in direct response to the opioid crisis in the United States and the increasing use of opioids as painkillers.

With Key Messaging, the goal is to facilitate awareness of the risks of opioids as a treatment option and encourage patients to discuss the risks and benefits with their care providers.

Combating Addiction with Action

In adding Key Messaging, WiserTogether joins a growing movement throughout the United States fighting the opioid epidemic through education, awareness, and action.

As key players in the movement, U.S. healthcare organizations and government agencies are making an impact by introducing special programs aimed directly at opioid addiction.

Below are four of the programs that aim to address the opioid epidemic:

Overdose Lifeline, an Indiana-based nonprofit, offers the "This is (Not) About Drugs" program for students. This one-of-a-kind educational program addresses the opioid health crisis specifically. The program has 150+ delivery partners and has reached 24,000 students in Indiana and 15 other states.

South Central PA Opioid Awareness Coalition offers a united front in the war against opioid and heroin abuse. It brings together health systems; hospitals and medical centers; dental and behavioral health providers; pharmacists; and healthcare professional associations to fight the opioid epidemic together.

In 2016, Cigna committed to reducing opioid abuse among its customers by 25 percent within three years. It has numerous initiatives underway to identify and help drive solutions to the opioid epidemic. Cigna also supports adoption of the National Pain Management Strategy and the new Centers for Disease Control and Prevention (CDC) Opioid Prescribing Guidelines.

Christiana Care Health System, Delaware, offers Project Engage -an early intervention and referral program. It helps hospital patients struggling with substance abuse including opioid misuse. Of the approximately 1,500 patients with substance use disorder offered help through the program, about 30% accepted treatment. Virtually no patients accepted help before Project Engage.

These programs are helping patients with drug addictions and dramatically cutting healthcare costs. An analysis of Project Engage data, for example, shows an average annual savings of about $6,000 per patient subsequent to their enrollment in the program.

The Final Word

The opioid crisis isn't a public health nuisance; it's a dangerous full-blown epidemic that doesn't discriminate. It can affect people from all walks of life and any age.

To help stem the tide of abuse, WiseTogether added the Key Messaging module to its Return to Health platform, which provides information and guidance to patients and helps cut healthcare costs. Key Messaging empowers people to make the best treatment choices for their needs.

In adding Key Messaging, WiseTogether joins a growing nationwide movement looking to address opioid addiction through awareness, education, and action.

The movement educates people on the dangers of opioid abuse, lets patients know that a serious addiction can start with a simple prescription, and provides help to those suffering from drug addiction.
Let us know what you think.
Thank you,

Max Kahn

# data[].attributes.attachment_link.title
Fighting the Opioid Epidemic Through Awareness and Education

# data[].attributes.attachment_link.description
Opioid abuse is a dangerous worldwide epidemic that continues to grow. According to the World Drug Report 2017, about 29.5 million people-or 0.6 percent of the global adult population-suffered from drug use disorders in 2015. Opioids were the most harmful drug type during that period, accounting for 70 percent of the negative health impact associated with drug use disorders.

# data[].attributes.body
In this article, Michael R. Bloomberg, former mayor of New York City, writes about how the Opioid Epidemic can be solved by the use of certain specific steps. This article also has a video in which it talks more about the rising numbers in users and deaths.

# data[].attributes.body
hhs.gov gives background information about what the opioid epidemic really is. It takes researchers back to where it first began in the 1990’s up until modern-day. This page also gives information on overdose numbers, statistics as to how many people of started using opioids, how many people misuse opioids, and more.

# data[].attributes.body
German Lopez, senior correspondent for Vox, gives more background information about what the Opioid Epidemic is. He lists the negatives of this crisis and how the problem has gone on for decades as well as also giving statistics.

# data[].attributes.attachment_link.title
Painkillers now kill more Americans than any illegal drug

# data[].attributes.body
The National Institute of Drug Abuse researched and found out how many students in 8th and 12th grade used drugs. Unfortunately, they found that more than plenty of them did. These frightening statistics should raise alarms to parents, showing them what dangers their kids could be in. Even though this research was just in the University of Michigan, it doesn’t mean that other schools aren’t just as bad.

# data[].attributes.body
This article by MedlinePlus gives those struggling with opioid usage, options to get better. They offer information as to what treatments work and even provide places they may be able to go to get better.

# data[].attributes.attachment_link.readable_text
What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your health care provider. However, opioid abuse and addiction are still potential risks.

What are opioid abuse and addiction?

Opioid abuse means you are not taking the medicines according to your provider's instructions, you are using them to get high, or you are taking someone else's opioids. Addiction is a chronic brain disease. It causes you to compulsively seek out drugs even though they cause you harm.

What are the treatments for opioid abuse and addiction?

Treatments for opioid abuse and addiction include

Medicines

Counseling and behavioral therapies

Medication-assisted therapy (MAT), which includes medicines, counseling, and behavioral therapies. This offers a "whole patient" approach to treatment, which can increase your chance of a successful recovery.

Residential and hospital-based treatment

Which medicines treat opioid abuse and addiction?

The medicines used to treat opioid abuse and addiction are methadone, buprenorphine, and naltrexone.

Methadone and buprenorphine can decrease withdrawal symptoms and cravings. They work by acting on the same targets in the brain as other opioids, but they do not make you feel high. Some people worry that if they take methadone or buprenorphine, it means that they are substituting one addiction for another. But it is not; these medicines are a treatment. They restore balance to the parts of the brain affected by addiction. This allows your brain to heal while you work toward recovery.

There is also a combination drug that includes buprenorphine and naloxone. Naloxone is a drug to treat an opioid overdose. If you take it along with buprenorphine, you will be less likely to misuse the buprenorphine.

You may safely take these medicines for months, years, or even a lifetime. If you want to stop taking them, do not do it on your own. You should contact your health care provider first, and work out a plan for stopping.

Naltrexone works differently than methadone and buprenorphine. It does not help you with withdrawal symptoms or cravings. Instead, it takes away the high that you would normally get when you take opioids. Because of this, you would take naltrexone to prevent a relapse, not to try to get off opioids. You have to be off opioids for at least 7-10 days before you can take naltrexone. Otherwise you could have bad withdrawal symptoms.

How does counseling treat opioid abuse and addiction?

Counseling for opioid abuse and addiction can help you

Change your attitudes and behaviors related to drug use

Build healthy life skills

Stick with other forms of treatment, such as medicines

There are different types of counseling to treat opioid abuse and addiction, including

Individual counseling, which may include setting goals, talking about setbacks, and celebrating progress. You may also talk about legal concerns and family problems. Counseling often includes specific behavioral therapies, such as

Cognitive-behavioral therapy (CBT) helps you recognize and stop negative patterns of thinking and behavior. It teaches you coping skills, including how to manage stress and change the thoughts that cause you to want to abuse opioids.

Motivational enhancement therapy helps you build up motivation to stick with your treatment plan

Contingency management focuses on giving you incentives for positive behaviors such as staying off the opioids

Group counseling, which can help you feel that you are not alone with your issues. You get a chance to hear about the difficulties and successes of others who have the same challenges. This can help you to learn new strategies for dealing with the situations you may come across.

Family counseling/ includes partners or spouses and other family members who are close to you. It can help to repair and improve your family relationships.

Counselors can also refer you to other resources that you might need, such as

Peer support groups, including 12-step programs like Narcotics Anonymous

Spiritual and faith-based groups

HIV testing and hepatitis screening

Case or care management

Employment or educational supports

Organizations that help you find housing or transportation

What are residential and hospital-based treatments for opioid abuse and addiction?

Residential programs combine housing and treatment services. You are living with your peers, and you can support each other to stay in recovery. Inpatient hospital-based programs combine health care and addiction treatment services for people with medical problems. Hospitals may also offer intensive outpatient treatment. All these types of treatments are very structured, and usually include several different kinds of counseling and behavioral therapies. They also often include medicines.

# data[].attributes.attachment_link.title
Opioid Abuse and Addiction Treatment: MedlinePlus

# data[].attributes.attachment_link.description
Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery.

# data[].attributes.body
In this article written by medicinesafe.org, it provides not only multiple articles but also a video that help people struggling with the Opioid crisis. It helps people understand the crisis, gives an article so people can recognize the signs, and more.

# data[].attributes.attachment_link.readable_text
In 2018, the Center for Safe Internet Pharmacies (CSIP) and the Partnership for Drug-Free Kids (the Partnership) launched MedicineSafe, a coalition of national and state public and private partners, to provide expert information and tools for safely managing prescription drugs and opioid addiction. Our mission is to educate consumers, provide free resources and save lives.

# data[].attributes.attachment_link.title
MedicineSafe.org | Safely manage prescription drugs & opioid addiction

# data[].attributes.attachment_link.description
We are a growing coalition of national and state public and private partners facilitated by the Center for Safe Internet Pharmacies & the Partnership for Drug-Free Kids. Our mission is to educate consumers about safely managing prescription drugs & opioid addiction, provide free resources and save lives.

# data[].attributes.body
New York State Association of Counties created this PSA to show the world to pay more attention to this dangerous opioid crisis. It tells people to start to learn to recognize the signs before it’s too late

# data[].attributes.attachment_link.title
Opioid Awareness PSA: See the Signs, Save a Life

# data[].attributes.body
The FEND movements is a campaign in which people from all over host different types of events to raise awareness to the Opioid Epidemic. They do their best to inform teens about the danger of overdose through a language in which they can understand.

# data[].attributes.attachment_link.description
FEND will give you the facts. Our app has all the info you need to learn about opioids (and you can even win stuff as you learn). Too many people are dying or having their lives destroyed, and it's time to take a stand - for yourself and for each other.

# data[].attributes.body
This video from VWT Band Members,who are part of the FEND organization, recorded a short video with a few statistics. Even though it doesn’t have as much information, it still shows how unstable the Opioid Epidemic has gotten.

# data[].attributes.body
This blog by Centers for Disease and Prevention, really helps spread awareness for the Opioid Crisis. They talk about Rx Awareness and what this organization is fighting for. On top of that, they provide steps as to how to use opioids the correct and responsible way.

# data[].attributes.attachment_link.title
Raising Awareness to Prevent Prescription Opioid Overdoses

# data[].attributes.attachment_link.description
CDC - Blogs - Public Health Matters Blog - Raising Awareness to Prevent Prescription Opioid Overdoses - Sharing our stories on preparing for and responding to public health events

# data[].attributes.body
The UFC, which is a world premiered mixed martial arts organization, launched a campaign to bring attention to the devastating effects of the Opioid Epidemic. The article has information as to why they launched this campaign and a PSA video.

# data[].attributes.attachment_link.title
UFC® Launches Public Service Campaign To Raise Awareness Of The Dangers Of Opioid Addiction

# data[].attributes.attachment_link.description
According to the Center for Disease Control (CDC), drug overdoses are now the leading cause of death among Americans under 50, with two-thirds of all drug overdose deaths caused by opioids such as prescription painkillers. The CDC further estimates the total economic burden of prescription opioid misuse in the U.S.

# data[].attributes.body
The National Recreation and Park Association is trying their best to raise awareness. They have organized special events in which the people do activities to help gain attention to this cause. They based these ideas around the color purple and are using these events to get the people interested in helping.

# data[].attributes.attachment_link.readable_text
Unfortunately, many of us are now being both personally and professionally impacted by the opioid epidemic, whether because we've personally lost someone to addiction, know someone who is struggling with addiction in our community or the addiction crisis is now impacting our work as park and recreation professionals. In 2017, the U.S. Department of Health and Human Services (HHS) declared the opioid crisis a public health emergency.

Communities are trying to find solutions and comfort, coming together in an attempt to decrease the number of overdoses and fatalities, slow the rate of overprescribing by health providers and seek alternatives to pain management. Additionally, communities are starting to budget for supplementary funding for mental health, making this a priority and part of their strategic plans.

Every November, local governments celebrate "Municipal Government Works Month" by issuing proclamations, posting photos of employees and elected officials conducting business on social media, and sharing information to educate citizens about the role and function of government. The Maryland Municipal League (MML), a voluntary, nonprofit, nonpartisan association controlled and maintained by city and town governments that works to strengthen and support municipal government through advocacy and the development of effective leadership, seized the opportunity to celebrate "Municipal Government Works Month" by participating in the "Go Purple" movement.

The city of Gaithersburg, Maryland, joined MML and other local municipalities in the "Go Purple" movement to raise awareness about substance use and the opioid crisis. This initiative was created by The Herren Project, a substance abuse prevention program designed to engage and educate young people about the dangers of substance use. The Herren Project was established by former NBA player Chris Herren. The program empowers youth and the community to make positive and healthy life choices. The color purple symbolizes the healthy decisions we make each day.

It takes all of us - the entire village - to fight this battle. How did the Department of Parks, Recreation and Culture for the city of Gaithersburg become involved and what can you and your community achieve? Here are a few ideas, but with the creativity of parks and recreation professionals, I'm certain you can create an extensive list of what you can do!

Throughout the month of November, the staff (and elected officials) will wear purple on Wednesdays

The city's logo, the park and recreation department's Facebook page, staff signature lines and other outlets will be temporarily changed to purple

Select city facilities will be illuminated with purple lighting at night

When sharing on social media use #GoPurple

Have resource tables in the lobbies (or at your front desks) of facilities - literature/educational materials on addiction and where to get help

Facilities can be decorated with purple ribbons/streamers

Electronic message boards/digital signage can have a purple background for the month or black background with purple letters

Have D.A.R.E. Certified Police Officers and other nonprofit organizations who specialize in substance abuse prevention speak at your youth centers and/or hold a town hall meeting

Host a Narcan training for providers

Initiate or participate in an Opioid Overdose Task Force

Update your websites to include "addiction services" pages

Encourage your participants to become involved in this initiative for the month

Does the month matter? It does not. What matters is the fact that you become involved and take a stand. Dorchester County, Maryland (where I am a part time resident), "went purple" in the month of September. City and county buildings, including schools, had purple lights. Businesses and residents alike decorated their properties in purple lights and bows. The international Ironman (2.4 mile swim, 112 mile bike and 26.2 mile run), was held in Cambridge, Maryland, and all the volunteer shirts were purple and proceeds were donated to substance abuse centers.

NRPA is currently assessing the role park and recreation agencies are playing in combatting the opioid epidemic and how communities are responding. Do you have a story to share? Email NRPA's Senior Government Affairs Manager, Kate Clabaugh.

Michele R. Potter, CPRP, is the Director of Parks, Recreation and Culture for the City of Gaithersburg.

# data[].attributes.attachment_link.keywords[]
national recreation and park association

# data[].attributes.attachment_link.title
Going Purple to Raise Awareness about the Opioid Epidemic in Your Community

# data[].attributes.attachment_link.description
Unfortunately, many of us are now being both personally and professionally impacted by the opioid epidemic, whether because we've personally lost someone to addiction, know someone who is struggling with addiction in our community or the addiction crisis is now impacting our work as park and recreation professionals. In 2017, the U.S.

# data[].attributes.body
The AddictionCenter gives information to people about what they can do to help a person suffering from the Opioid Epidemic. They tell readers what opioids are, statistics, how opioids started, and more.

# data[].attributes.body
The Hazelden Betty Ford Foundation provide readers the signs of someone suffering from the opioid epidemic. They give treatment options and tell them about withdrawal symptoms as well.

# data[].attributes.attachment_link.readable_text
What are opioids? Why are opiate drugs so addictive and lethal? Does rehab work for opioid addiction?

As declared by the National Institute on Drug Abuse and the Centers for Disease Control and Prevention, the U.S. is in the midst of an opioid epidemic. It's more important than ever to understand how prescription painkillers, heroin and other opiate drugs work, why dependence on opioids can develop before you realize it, and which treatment approaches and rehab options are most effective.

What Are Opioids?

"Opioids" is an umbrella term for natural and synthetic painkillers derived from or based on the poppy plant. The related term "opiate" applies only to medications that use natural opium poppy products. For example, the drug heroin is an opiate. Physicians often prescribe opioids to relieve acute pain-from injuries, surgeries, toothaches or other medical and dental procedures-or to alleviate chronic pain. However, studies show that long-term use of opioids for chronic pain is ineffective-and comes with the risk of addiction.

You might recognize the names of some of the more well-known opioid drugs prescribed for pain, including:

Morphine

Codeine

Heroin (Diacetylmorphine)

Hydromorphone (Dilaudid)

Hydrocodone (Vicodin, Lortab)

Opium

Oxycodone (OxyContin, Percocet)

Oxymorphone

Meperidine (Demerol)

Methadone

Fentanyl (Sublimaze, Actiq)

Tramadol

How Do Opioids Work?

When opioid molecules travel through the bloodstream and into the brain, they attach to receptors on the surface of certain cells. The chemical response triggered in the brain's reward center is the same as the reaction to intense pleasure and reinforces acts such as eating, drinking fluids, caring for babies and having sex-all necessary for survival of the species.

These rewarding and survival-based activities result in release of dopamine in the brain's reward center. But opioids, like all drugs of abuse, trigger the release of dopamine in excess amounts, far beyond what is needed to provide pleasure or keep us alive. The brain has been signaled: Something extremely important has taken place, and it needs to be repeated.

Symptoms and Side Effects of Opioid Abuse

Anyone exposed to opioids will experience excess dopamine release in the reward center of the brain. However, most people do not become addicted after such exposure. Your risk of dependence is higher if you or someone in your family has a history of substance abuse. Although most people take prescription painkillers responsibly and as prescribed, there has been an increase in nonmedical use of prescription opioids in the United States.

Signs and symptoms of opioid intoxication include:

Problematic mental health, behavioral or psychological changes such as agitation, poor judgement or apathy

Drowsiness or coma

Impaired attention or memory

Slurred speech

Constricted pupils

Side effects of opioid abuse can include:

Dry mouth

Drowsiness

Nausea

Constipation

Abdominal cramping

Depressed respiration

Skin rashes

Weight gain

Menstrual problems

Depression

Headaches

Bad dreams

Loss of libido, sexual dysfunction

Mood swings

Signs of an overdose emergency may include nervous system changes, decreased vital signs, cold or clammy skin or bluish lips.

Opioid use also can induce euphoria, an effect that can be intensified when the drug is administered by routes other than those prescribed or recommended. For example, the prescription painkiller OxyContin can be snorted or injected to enhance its euphoric effects. Unintended consequences of misusing opioid drugs in this way can include serious medical problems, even opioid overdose.

Opioid Dependence

Addiction is defined as the compulsive and uncontrollable use of drugs despite adverse consequences. Dependence occurs when the body adapts to the presence of a drug, causing withdrawal symptoms when drug use is reduced or discontinued.

Prolonged and increasingly higher doses of opiate drugs changes the brain so that it functions more or less normally when the drug is present and abnormally when the drug is removed. This alteration in the brain results in drug tolerance (the need to take higher and higher amounts to achieve the same effect; "chasing the dragon") and opioid dependence (susceptibility to withdrawal symptoms).

Euphoria is the sensation most opioid users seek, but it's also the effect most likely to diminish with regular opioid abuse. Prolonged use changes the brain's opioid receptors at a cellular level, a protective response against overstimulation.

That's why it's said an opioid addict uses the drug in order to feel "normal. Many people assume addicts take pleasure in their daily substance abuse, but most people who develop opioid dependence cannot recall the last time their drug use was enjoyable. After a certain point, substance abuse and dependence becomes drudgery and its own form of torture.

Symptoms of opioid dependence include:

Taking the drug in larger amounts or over a longer period than intended or prescribed

A persistent desire or unsuccessful efforts to cut down or control opioid use

An excessive amount of time and effort spent getting and using opioids and recovering from the effects of drug abuse

Intense cravings or a strong desire or urge to use opiates

Failure to fulfill obligations at work, school or home due to drug abuse

Continued use of opiates despite persistent or recurrent social or personal problems caused by usage

Continued use despite situations which could be physically hazardous

Continued use despite awareness of potential physical or psychological problems

Taking a large single dose of an opioid can cause severe respiratory depression with the potential for accidental drug overdose and death. Opioid abuse is also associated with a higher risk of suicide.

Opiate Withdrawal and Relapse

Opioid withdrawal can be especially challenging. In fact, the fear of experiencing severe opiate withdrawal symptoms prevents many addicts from getting the help they need and deserve. Opioid withdrawal symptoms include:

Restlessness

Muscle aches, pain stiffness spasms and bone pain

Insomnia

Diarrhea

Vomiting

Cold flashes with goose bumps ("cold turkey")

Involuntary leg movements

Agitation

Anxiety, panic

Itching

Irritability

Rapid heart rate

Mild hypertension

Runny nose

Sweating, shaking

Flu-like symptoms, fever

Yawning

Seizures

Sleep difficulties

Fear, paranoia

At the height of opiate withdrawal, symptoms typically include intense anxiety, tremors, shakes, muscle cramps and joint and deep bone pain begin to manifest.

Down the road are more serious, long-term consequences of opiate withdrawal. Anxiety, depression and cravings can continue for months, even years after being free of use. Addicts in recovery also have an increased sensitivity to real or imagined pain and are more vulnerable to stressful events.

The desire to feel "normal" again, to escape this seemingly permanent state of dysphoria, puts addicts at a high risk of relapse, and, even more tragically, at a high risk of accidental opioid overdose and death. A user who returns to the same dosage after losing his or her drug tolerance risks respiratory suppression and death.

Treatment for Opioid Use Disorder

Because of the unique challenges in addressing opiate addiction, and because of the addict's vulnerability to relapse and accidental death, Hazelden Betty Ford developed enhanced opioid addiction treatment protocols that include the use of certain medications, extended continuing care and close monitoring of medication use. These addiction treatment protocols are known as the Comprehensive Opioid Response with Twelve Steps (COR-12™). The approach is designed to provide addicts with a sufficiently long enough time in recovery to begin forming new relationships and taking in new information essential to addiction recovery. Treatment is delivered within the context of Twelve Step Facilitation and other evidence-based therapies, with abstinence from drugs as the ultimate goal.

As part of the COR-12 addiction treatment protocol, physicians work with each patient to determine the treatment course that best fits his or her clinical needs. Patients may receive Suboxone®, a combination of buprenorphine and naloxone, for detox to ease withdrawal symptoms. Some patients may receive a recommendation for a monthly, extended-release injection of Vivitrol®, also known as naltrexone, to ease cravings. This medication works to block cravings and help prevent relapse. Although methadone is commonly used to ease opioid/opiate withdrawal, Hazelden Betty Ford provides buprenorphine instead, for a number of important reasons. Buprenorphine has been deemed a better medication for the Hazelden Betty Ford Foundation's patient population, in keeping with the goal of transitional use of medication-assisted treatment versus long-term medication maintenance. Learn more about methadone vs suboxone for treatment of opiate addiction and withdrawal.

Learn more about our medication-assisted opioid addiction treatment program.

You may also be interested in Prescription Painkillers: History, Pharmacology, and Treatment by Marvin D. Seppala, MD (Hazelden Publishing, 2010).

Partially excerpted from Prescription Painkillers by Marvin D. Seppala, MD, chief medical officer of the Hazelden Betty Ford Foundation.

# data[].attributes.attachment_link.title
Opioid Addiction: Dependence, Symptoms and Treatment

# data[].attributes.attachment_link.description
What are opioids? Why are opiate drugs so addictive and lethal? Does rehab work for opioid addiction? As declared by the National Institute on Drug Abuse and the Centers for Disease Control and Prevention, the U.S. is in the midst of an opioid epidemic.

# data[].attributes.body
The American Physical Therapy Association gives 7 “staggering” facts about the opioid crisis. It shines light on how truly dangerous this crisis is.

# data[].attributes.attachment_link.readable_text
Every year millions of Americans use opioids to manage pain. Doctor-prescribed opioids are appropriate in some cases, but they just mask the pain-and reliance on opioids has led to the worst drug crisis in American history.

The Centers for Disease Control and Prevention (CDC), the American College of Physicians, and the National Academies of Sciences, Engineering, and Medicine have issued guidelines and reports urging health care providers to pursue safe nondrug alternatives, including physical therapy, for most non-cancer-related pain treatment.

Physical therapists (PTs) treat pain through movement, hands-on care, and patient education-and by increasing physical activity you can also reduce your risk of other chronic diseases. A recent study published in Health Services Research found that patients who saw a PT before trying other treatments for low back pain were 89% less likely to needan opioid prescription.

Statistics from the CDC, the Agency for Healthcare Research and Quality, and the United States (US) Department of Health and Human Services reveal the gravity of the problem.

1. In 2016, health care providers across the US wrote more than 214 million prescriptions for opioid pain medication-a rate of 66.5 prescriptions per 100 people.

2. As many as 1 in 5 people receive prescription opioids long-term for noncancer pain in primary care settings.

3. More than 11 million people abused prescription opioids in 2016.

4. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.

5. More than 40% of all US opioid overdose deaths in 2016 involved a prescription opioid.

6. Drug overdoses claimed the lives of nearly 64,000 Americans in 2016. Nearly two-thirds of these deaths (66%) involved a prescription or illicit opioid.

7. The CDC estimates the total economic burden of prescription opioid misuse in the US is $78.5 billion a year, including the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.

If you know someone in pain, encourage them to talk to their physician or PT about safe ways to manage pain.

The American Physical Therapy Association's #ChoosePT campaign is raising awareness about the dangers of prescription opioids, and encourages consumers and prescribers to choose safer alternatives like physical therapy for most chronic pain management.
Bibliography
Centers for Disease Control and Prevention. US drug overdose deaths continue to rise; increase fueled by synthetic opioids. Updated March 29, 2018. Accessed July 26, 2018.

Centers for Disease Control and Prevention. Prescribing data. Updated August 30, 2017. Accessed July 26, 2018.

Centers for Disease Control and Prevention. Opioid basics. Updated August 27, 2017. Accessed July 26, 2018.

Centers for Disease Control and Prevention. Prescription opioid overdose data. Updated August 1, 2017. Accessed July 26, 2018.

Centers for Disease Control and Prevention. US prescribing rate maps. Updated July 31, 2017. Accessed July 26, 2018.

U.S. Department of Health and Human Services, Office of the Surgeon General. Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: US Department of Health and Human Services; 2016. Accessed July 26, 2018.

Florence CS, Zhou C, Luo F, Xu L. The economic burden of prescription opioid overdose, abuse, and dependence in the United States, 2013. Med Care. 2016;54(10):901-906. Free Article.

# data[].attributes.attachment_link.title
7 Staggering Statistics About America's Opioid Epidemic

# data[].attributes.attachment_link.description
Every year millions of Americans use opioids to manage pain. Doctor-prescribed opioids are appropriate in some cases, but they just mask the pain-and reliance on opioids has led to the worst drug crisis in American history.

# data[].attributes.body
The Health Resources and Services Administration show the different ways they are trying to battle the Opioid Epidemic. They are doing this through the use of research, health centers, primary care, and more.

# data[].attributes.attachment_link.description
The Nation is in the midst of an unprecedented opioid epidemic. More than 130 people a day die from opioid-related drug overdoses.Prevention and access to treatment for opioid addiction and overdose reversal drugs are critical to fighting this epidemic. Primary care settings have increasingly become a gateway to better care for individuals with both behavioral health (including substance use) and primary care needs.

# data[].attributes.body
National Capital Poison Center talks about the background and history of the Opioid Epidemic. It gives readers the full story, references, and additional information.

# data[].attributes.attachment_link.readable_text
The Full Story

The opioid epidemic has occurred in three waves. The podcast episode, "Introduction to the Opioid Epidemic" explains these waves in greater detail. The first wave began in 1991 when deaths involving opioids began to rise following a sharp increase in the prescribing of opioid and opioid-combination medications for the treatment of pain. The increase in opioid prescriptions was influenced by reassurances given to prescribers by pharmaceutical companies and medical societies claiming that the risk of addiction to prescription opioids was very low. During this time, pharmaceutical companies also began to promote the use of opioids in patients with non-cancer related pain even though there was a lack of data regarding the risks and benefits in these patients. By 1999, 86% of patients using opioids were using them for non-cancer pain. Communities where opioids were readily available and prescribed liberally were the first places to experience increased opioid abuse and diversion (the transfer of opioids from the individual for whom they were prescribed, to others, which is illegal).

The second wave of the opioid epidemic started around 2010 with a rapid increase in deaths from heroin abuse. As early efforts to decrease opioid prescribing began to take effect, making prescription opioids harder to obtain, the focus turned to heroin, a cheap, widely available, and potent illegal opioid. The use of heroin increased in both sexes, the majority of age brackets, and all socioeconomic groups. Deaths due to heroin-related overdose increased by 286% from 2002 to 2013, and approximately 80% of heroin users admitted to misusing prescription opioids before turning to heroin. Heroin is commonly injected, which puts users at risk for injection-related diseases like HIV/AIDS, hepatitis B and C, skin infections, bloodstream infections, and infections of the heart.

The third wave of the epidemic began in 2013 as an increase in deaths related to synthetic opioids like fentanyl. The sharpest rise in drug-related deaths occurred in 2016 with over 20,000 deaths from fentanyl and related drugs. The increase in fentanyl deaths has been linked to illicitly manufactured fentanyl (not diverted medical fentanyl) used to replace or adulterate other drugs of abuse.

In an effort to reduce risk and maximize the benefits of available pain treatment options, the US Centers for Disease Control and Prevention (CDC) issued comprehensive guidelines for prescribing opioids for chronic pain outside of cancer treatment, palliative care, and end-of-life care. These prescribing recommendations say that non-opioid treatments are the preferred first step for treatment of chronic pain. Opioid medications should only be added after careful assessment of pain control and followed by regular evaluations of their continued need.

Attempts to change opioid prescribing patterns have been opposed primarily by indirect intervention by the pharmaceutical industry through lobbying and advocacy groups. These efforts include attempts to halt measures to restrict opioid overprescribing, efforts to undermine the CDC guidelines, and thwarting attempts to hold prescribers and pharmaceutical companies accountable. Researchers from two universities found that the opposition to the CDC guidelines was significantly more common among organizations that received funding from opioid manufacturers. An investigation by the US Senate Committee on Homeland Security and Governmental Affairs detailed the financial ties that exist between opioid manufacturers, advocacy groups, and medical professional societies. The report exposed patient advocacy groups and professional societies spending millions of dollars to promote messages and policies favoring the interests of the pharmaceutical industry.

Lindsy Liu, PharmD
Certified Specialist in Poison Information

Diana N. Pei, PharmD
Certified Specialist in Poison Information

Pela Soto, PharmD, BSHS, BS
Certified Specialist in Poison Information

Before receiving a prescription for an opioid drug, ask the prescriber if there are effective non-opioid treatments.

Follow medication instructions carefully.

Store medications in a safe and secure location away from children, pets, and those who might abuse them.

Do not take opioid medications with alcohol, illegal drugs, or other medications that could affect breathing.

Learn more about the opioid epidemic on our podcast.

# data[].attributes.attachment_link.description
The opioid epidemic has occurred in three waves. The podcast episode, "Introduction to the Opioid Epidemic" explains these waves in greater detail. The first wave began in 1991 when deaths involving opioids began to rise following a sharp increase in the prescribing of opioid and opioid-combination medications for the treatment of pain.

# data[].attributes.body
PBS News gives information about how the U.S got to the state it’s in now because of the Opioid Epidemic.

# data[].attributes.attachment_link.readable_text
It's hard to grasp the full scope and scale of the opioid crisis we're in the midst of.

The numbers are staggering. Almost half-a-million Americans have died in the last 15 years from an overdose, and the majority of those involve opioids. On average, 91 Americans are still dying every single day.

In that same period, the rate of addiction to opioids has shot up by almost 500 percent. And the availability of addiction treatment hasn't kept up at all.

So, how did we get here?

Most experts say this crisis began in the 1990s, when some doctors and medical associations argued that, for generations, their profession had ignored the problem of chronic pain, which had caused unnecessary suffering for millions of patients.

They started pushing the idea that pain be seen as the fifth vital sign, something to be checked as often as blood pressure, and treated accordingly.

At roughly the same time, the pharmaceutical industry, which was eager to boost sales of its new class of painkillers, like OxyContin, told doctors that these new drugs could be used without fear of their patients becoming addicted.

The industry even put out testimonial videos, like this one from Purdue Pharma in 2000.

# data[].attributes.attachment_link.title
Opioid addiction is the biggest drug epidemic in U.S. history. How'd we get here?

# data[].attributes.attachment_link.description
Every day brings another story about the depth of the country's opioid crisis. A rise of pain killer prescriptions from doctors and a pharmaceutical industry eager to boost sales in the 1990s sparked a wave of addiction that shot up by almost 500 percent in the last 15 years.