Barbara E. Kaplan, MHDL

Counseling for Individuals, Couples, Partners, Marriages, Families


What is this Opioid Epidemic About?

The U.S. Department of Health and Human Services (HHSI) reports that with respect to opioid use for year 2016: 116 persons died every day from opioid-related drug overdoses,” 2.1 million "had an opioid use disorder,” 11.5 million “misused prescription opioids,” and 17,087 deaths are “attributed to overdosing on commonly prescribed opioids.”

Between years 1999 and 2014, the age group with the highest opioid overdose rate was 25 to 54 years old. 

According to the Centers for Disease Control and Prevention (CDC), most of the drug overdose deaths in the US involve an opioid and there has been a fourfold increase in these overdose deaths from 1999 to 2015!  Even more alarming is the increase in number of deaths due to prescription opioids: 5 times greater in 2016 than in 1999!

Greater than a 1000 people receive treatment in emergency departments daily from misuse of opioid prescriptions.

What prescription opioid drugs are mostly involved in these deaths?

Oxycodone, Methadone and Hydrocodone.

What may account for this increase in overdose opioid deaths?

According to the CDC,

We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths. The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010 yet there had not been an overall change in the amount of pain that Americans reported.

And according to the CDC, almost 250 million opioid prescriptions were written in 2013 which “is enough for every American to have their own bottle of pills.”

National Institutes of Health (NIH) reports that in:

… the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive.3,4  Opioid overdose rates began to increase.  In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.1  That same year, an estimated 2 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive).5  Here is what we know about the opioid crisis:
  • Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.6
  • Between 8 and 12 percent develop an opioid use disorder.7–9
  • An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.7–9
  • About 80 percent of people who use heroin first misused prescription opioids.

Prescription opioids include but are not limited to the following: Fentanyl, Dilaudid, Vicodin, Lorcet. Lortab, Norco, Demerol, Dolophine, Percocet, Codeine, Actiq, Fentora, OxyContin.  The opioid drug binds to opioid receptors (tiny parts of nerve cells) in the body, specifically the brain and spinal cord (but other parts of the body as well such as the limbic system which controls emotions) to decrease the intensity of pain.  The body naturally produces its own opioid-like molecules to affect pain but often cannot decrease feelings of severe pain.


According to the CDC, “Death from an opioid overdose happens when too much of the drug overwhelms the brain and interrupts the body’s natural drive to breathe.”  

According to the CDC, the signs of opioid overdose include:

  • Small, constricted "pinpoint pupils"
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing
  • Choking or gurgling sounds
  • Limp body
  • Pale, blue, or cold skin

What may help when someone overdoses?

The medication, naloxone is designed to be administered via injection or can be sprayed into a nostril to quickly reverse an opioid overdose.  As specified above, opioid drugs bind to opioid receptor sites.  Naloxone works by blocking these opioid receptor sites.

Some states permit family members, friends and others to administer the nasal spray and prefilled auto-injection device.  Pharmacies in some states permit dispensing this medication without a physicians’ prescription.  Other states require a physician’s prescription.

Withdrawal symptoms may occur for the person who received Naloxone such as vomiting, nausea, restlessness, running nose, tremors, increase in heart rate.   

There is the possibility that persons may have an allergic reaction to Naloxone and if this is the case, it’s important to receive immediate medical help.  According to the Substance Abuse and Mental Health Services Administration (SAMHSA), if there is an allergic reaction, “They should not drive or perform other potentially unsafe tasks.”

What’s being done about this crisis?  

According to NIH:

...  the U.S. Department of Health and Human Services (HHS) is focusing its efforts on five major priorities:

  1. improving access to treatment and recovery services
  2. promoting use of overdose-reversing drugs
  3. strengthening our understanding of the epidemic through better public health surveillance
  4. research on pain and addiction
  5. advancing better practices for pain management

NIH, a component of HHS, is the nation's leading medical research agency helping solve the opioid crisis via discovering new and better ways to prevent opioid misuse, treat opioid use disorders, and manage pain.  To accelerate progress, NIH is exploring formal partnerships with pharmaceutical companies and academic research centers to develop:

  1. safe, effective, non-addictive strategies to manage chronic pain
  2. new, innovative medications and technologies to treat opioid use disorders
  3. improved overdose prevetion and reversal interventions to save lives and support recovery

What is the economic burden of the opioid crisis?

It’s staggering!  According to the November 20, 2017 CEA Report: the Underestimated Cost of the Opioid Crisis, the estimated cost was 504 billion dollars for year 2015!

Is there treatment for Opioid Use Disorder?

Effective treatment for Opioid Use Disorder is available: detoxification, medication (e.g., buprenorphine), inpatient and outpatient mental health counseling, relapse prevention.  Types of mental health treatment may include but not be limited to Contingency Management, Cognitive-Behavioral therapy.  Contingency Management, also referred to as Motivational Incentive, is utilized in community treatment programs using rewards for patients who abstain from opioids and other drugs.  Cognitive Behavioral Therapy may be utilized in inpatient and outpatient treatment settings with individuals and groups.   It assists clients in acquiring skills in an effort to achieve long-term abstinence.   Cognitive Behavioral Therapy (CBT) recognizes that one’s feelings and behavior are largely influenced by one’s thought(s).  It consists of identifying, testing and correcting unhealthy thinking to change the view of self and the world in an effort to decrease psychological disturbance, unwanted, problematic and self-destructive behaviors and improve functioning.  There is a focus on acquiring skills.  These learned skills may be applied during and following counseling to aid in obtaining and maintaining abstinence from drug use and throughout life to apply to other issues or problems such as relationship difficulties, stress, anxiety, depression, anger.

This article was written some time between January 1, 2016 and January 22, 2019.

For additional information about counseling regarding opiods issues or counseling in general, please call 704 333-1510.

This article is solely for information purposes.   It is not advice.   It is not intended for minors, and minors are instructed to leave the site.   It is not intended and it does not constitute professional or clinical advice.  The user of this page should not take any steps, or refrain from taking any steps, based on the information in this page, but should instead consult a qualified mental health professional.