Deaths related to opioid overdoses in the United States began to rise in the late 1990s after decades of primarily heroin-related overdoses in mostly urban areas.
Much of the increase in opioid-related deaths in the early 2000s can be attributed to the increase in prescription opioids driven by aggressive pharmaceutical company marketing campaigns that convinced the Food and drug administration, providers and patients that these new opioid painkillers are not addictive. After nearly two decades of rising overdose deaths, the opioid crisis was finally declared a public health emergency in 2017.
“The initial issues were prescription opioids,” Johnson said. “Many state and federal policy changes, such as prescription drug monitoring programs, have made prescription opioids more difficult to obtain. So the epidemic kind of shifted from prescription opioids to heroin. We started to get a little bit under control, and then we started to see the fentanyl epidemic. Fentanyl is a synthetic opioid that is 100 times more potent than morphine. »
Johnson said about two-thirds of overdose deaths are linked to fentanyl and other synthetic opioids. This is because many times people take pills that they think are oxycodone, but unfortunately have been mixed with fentanyl.
Over the past decade, Johnson and others have worked with doctors and providers to get waivers to prescribe buprenorphine, a drug designed to treat opioid use disorder. However, he mentioned that some providers resisted offering the drug, often saying they didn’t want addiction patients in their practice – even though they were already there.
“People you meet every day have issues with opioid use disorder, substance use disorder, and alcohol use disorder. We’re just trying to give them a tool to effectively treat patients who come into their practice,” Johnson said.
“I think there’s a misconception about the type of people who could potentially have opioid use disorder. A lot of times you’ll see teenagers or 20’s who were athletes and maybe had a broken leg in high school and had to get a prescription for oxycodone and because of the way their brain is wired they became addicted to these prescription pills relatively quickly.
Opioid overdose deaths have plagued the Appalachian region, including several areas of North Georgia. While overdose deaths in Georgia exceed the number of motor vehicle-related deaths each year, Georgia has fared better than many other states.
“I tell a lot of people Georgia got really lucky. If you look at the overdose rates and other issues across the country, given our size, I think we got lucky” , Johnson added.
Part of that credit goes to the state’s active involvement with community organizations that implement programs to help people who may be addicted to opioids. The Addiction and Mental Health Services Administration provided a grant to IPPH to help six federally licensed health centers across the state implement an alcohol and drug testing intervention.
Other grants facilitate partnerships with rural healthcare providers who are taking a holistic approach to addressing the opioid epidemic.
Trying to get waivers for doctors, nurse practitioners and other healthcare providers to prescribe buprenorphine is a big step in the right direction, Johnson said. Grant money is also being used to get naloxone, an opioid overdose drug, into the hands of first responders.
“If someone experiences an opioid overdose while in an ambulance or police car, they will have the medications they need to reverse that overdose,” he said. “Through the grant, we purchased naloxone kits for each of the medical students here in Georgia Medical College because they’re all going to do a clinical rotation at some point and we want them to have a kit with them.
Funding to help fight the opioid epidemic is a big hurdle to jump. Johnson said recent court rulings against drug companies are helping the state’s fight – and more support could be on the way.
“Over the past four or five years there have been numerous lawsuits filed against these pharmaceutical companies and the Georgia State Attorney General has joined these lawsuits. So what is very likely to happen is that a significant amount of settlement funds will come to Georgia. »