The Newest Ways To Combat Opiate Abuse
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The Newest Ways To Combat Opiate Abuse


In the rooms of Narcotics Anonymous and Alcoholics Anonymous, many people have racked up decades of clean time. But it’s disturbingly common to hear old timers share cautionary tales of relapsing even after 12 or 15 years clean. More often than not, when someone “goes out” after that many years, prescribed painkillers are the culprit. Even people who originally never preferred stimulants have stumbled after surgeries when they found themselves holding scripts for Vicodin or OxyContin.

A Prescription for Addiction

From football players to suburban housewives, an increasing number of Americans are hooked on prescription opioids, which in turn is fueling the country’s heroin epidemic as addicts switch from pills to street drugs. This trend has sparked concern within the health care industry—including a growing movement to reduce opioid prescription.

Pharmaceutical makers have responded to the crisis by creating modified opioids that are “abuse-deterrant.” Take Targiniq, approved last month by the FDA. Expressly designed to discourage abuse, it combines Oxycodone—the king of prescription opiates—with Naloxone, which EMTs administer as an antidote to heroin overdoses. The Naloxone actually blocks Oxycodone’s euphoric effects, so instead of inducing a heroin-like high, snorting or injecting Targiniq would be thoroughly underwhelming. Despite these admittedly helpful measures, though, the FDA warns that Targiniq can still be abused, especially when taken orally—which is the main way most addicts get hooked on Oxy in the first place.

Treating A Drug Problem with More Drugs

It’s easy to see, then, why many health professionals aren’t satisfied with these abuse-resistant opioids. In the words of Dr. Andrew Kolodny, the president of Physicians for Responsible Opioid Prescribing, “If doctors believe Targiniq is safe, they may be more inclined to prescribe it instead of seeking alternatives.” For Kolodny, simply inventing pills that are harder to abuse is not enough. In order to curb the deadly trend, we must prioritize pain treatments that don’t ultimately tie back to opium poppies.

That sounds like a tall order. At most hospitals, opioids are the default for all post-op patients, regardless of their histories. Conventional wisdom holds that nothing else is as effective at knocking out pain. Since opioids are viewed as the gold standard for pain treatment, potential complications like dependence and overdose are treated as regrettable but inevitable risks.

A New Plan for Pain

But some hospitals, such as California Pacific Medical Care Center and St. Mary’s, are pioneering a bold new approach to pain treatment. Instead of a one-size-fits-all model that normalizes addictive pills, they are using a “multimodal pain regimen” in which non-narcotic pain medications serve as the first line of defense, while opioids are merely a last resort for extreme pain.

The star player in this new model is a new local analgesic called Exparel. Besides being non-opioid-based, it also has the advantage of being administered just once—during the surgery itself. Its effects last for three days, usually when pain is most acute, frequently eliminating the need for a bottle of pills. Unsurprisingly, the hospitals that have embraced these non-narcotic alternatives have seen big drops in the number of patients who need opioids. By extension, dependency cases have dropped too.

Doctors like Kolodny hope that speaking out against reckless prescription of addictive painkillers will cause a paradigm shift in the world of health and medicine. If enough hospitals reduce their reliance on opioids and promote alternative treatments, perhaps we will finally begin to make headway combatting the rising tide of opiate addiction.

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About Author

Erica Larsen AKA Eren Harris blogs at Whitney Calls and Clean Bright Day. Their writing has also been published on Salon, Selfish, Violet Rising and YourTango. They live in Los Angeles with their husband and their enormous cat.