Misusing painkillers can kill you; millions affected by global opioid crisis

Hyderabad: Opioids have long been recognised as potent pain-relievers, but their misuse and the alarming consequences have now placed them at the center of a global health crisis.

Opioids encompass compounds derived from the poppy plant (Papaver somniferum), as well as synthetic and semisynthetic counterparts that interact with the brain’s opioid receptors. While opioids, such as morphine and tramadol, have vital roles in pain management, their non-medical use and misuse have dire consequences, including opioid dependence and overdose.

Opioids can induce addictive euphoria

Dr Aisha Sharma, a prominent Indian de-addiction specialist, said, “Opioids are a double-edged sword. When used appropriately under medical supervision, they provide much-needed relief to patients in pain. However, their misuse and diversion for non-medical purposes pose grave risks.”

Opioids exert analgesic and sedative effects, making them effective tools in managing pain. Medications like morphine and fentanyl have been cornerstones in healthcare for years.

Others, such as methadone and buprenorphine, play a crucial role in maintaining opioid dependence. Unfortunately, opioids’ ability to induce euphoria has led to their misuse and dependency.

Millions affected globally

The World Health Organization (WHO) has sounded the alarm on the global opioid crisis. Worldwide, about 296 million people used drugs at least once in 2021, with approximately 60 million using opioids. Alarmingly, around 39.5 million people grappled with drug use disorders in 2021. The opioid crisis is not confined to a single nation; it’s a global challenge.

Opioid use can lead to fatalities due to their effects on the brain’s respiratory regulation centre. Opioid overdose manifests with pinpoint pupils, unconsciousness, and breathing difficulties.

In 2019, nearly 600,000 deaths worldwide were attributed to drug use, with opioids being responsible for nearly 80 per cent of these fatalities, and opioid overdose accounting for about 25 per cent of them.

Dr Rahul Kapoor, an Indian medical expert specialising in addiction, said, “Opioid overdose is an urgent concern. It is critical to recognise the signs and act promptly to save lives. Every second counts.”

Opioid problem in India

India, too, faces the opioid challenge. While most people dependent on opioids resort to illicitly cultivated and manufactured heroin, the misuse of prescription opioids is on the rise. Factors contributing to the crisis include the availability of opioids for chronic pain management and the influx of potent synthetic opioids in the illicit drug market.

Fentanyl, a synthetic opioid, has come under the spotlight. Approximately 50-100 times more potent than morphine, it is listed on the WHO Model List of Essential Medicines. However, illicitly manufactured fentanyl and its analogues, including carfentanil and acetyl fentanyl, have triggered a surge in opioid overdose deaths.

Drug dealers often add these substances to their products, sometimes selling them as counterfeit tablets, making it challenging for users to gauge the risks they face.

Pre-existing conditions can lead to opioid overdose

Several risk factors contribute to opioid overdoses, including having an opioid use disorder, injecting opioids, resuming opioid use after a period of abstinence, high prescribed opioid dosages, and concurrent use of other substances or medications that suppress respiratory function.

Dr Ravi Joshi, an Indian addiction specialist, warned, “It’s crucial for healthcare providers to identify patients at risk and take preventive measures to avoid overdose.”

Naloxone can reverse overdose

Preventing opioid overdose-related deaths is possible through timely intervention. Naloxone, an opioid antidote, can reverse overdose effects when administered promptly. Access to naloxone, however, remains limited in many regions.

Dr Priya Malik, an Indian emergency physician, stated, “Naloxone can save lives, but its availability is a concern. Efforts should focus on making it widely accessible to those who might witness an opioid overdose.”

Prevention and hope

Preventing opioid overdose necessitates a multifaceted approach. It involves increasing access to opioid dependence treatment, rationalising opioid prescribing, monitoring prescription practices, and limiting over-the-counter opioid sales.

Dr Sanjay Verma, an Indian public health advocate, stressed, “Prevention is the key to overcoming the opioid crisis. By addressing the root causes and providing comprehensive care, we can offer hope and recovery to those affected.”