The Opioid Crisis

This post was written by a CSUCI student.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) (2020), 1.6 million people had an opioid use disorder and 745,000 people consumed heroin in 2019. This number shows that the opioid crisis is an ongoing issue that started a while ago. There is a demographic characteristic of the opioid epidemic. National Institute on Drug Abuse (NIDA) (2020) shows in their data that men are more likely to use almost all types of illicit drugs compared to women, and the use of illicit drugs affects men more negatively than women by resulting in emergency room visits or deaths from overdose.

The opioid epidemic seems to be happening frequently among young adults. Hudgins et al. (2019) state that 32.2 percent of young adults (18-25 years of age) respondents had used prescription opioids. Also, their study found that more females reported the use of prescription opioid and non-Hispanic whites and Blacks tended to have had any opioid use more than Hispanics (Hudgins et al. 2019). According to County Opioid Abuse Suppression Taskforce (COAST) (2022), in 2021, 421,649 opioid prescriptions were reported in Ventura County. It shows that this crisis is not only nationwide but also local. With those numbers, there are a significant number of opioid users including prescribed and/or illicit drugs, and young adults are at a great risk to misuse.

It is hard to know how many people actually overdose on opioids; however, some facts show recent trends. Saloner et al. (2018) state that overdose rates are rising most among African Americans compared to all demographic groups. Moreover, COAST (2022) reports 135 opioid overdose incidents in Ventura County in 2021, 72 percent of them male and 28 percent female. Their data also shows that 29 percent of overall opioid overdose is at the age of 21-29 (COAST 2022).

As opioid overdose rates increase, death rates also rise. About 92,000 persons died from drug-related overdose in 2020. (NIDA 2022). Besides, Centers for Disease Control and Prevention (CDC) (2022) reports that about 75 percent of the 91,799 drug-related overdose deaths in 2020 involved an opioid. In addition, there were noteworthy changes in opioid-involved death rates from 2019 to 2020; those rates increased by 38 percent and that of prescription opioid-involved death rates boosted by 17 percent (CDC 2022). Furthermore, NIDA (2020) describes that 7,109 women and 9,978 men died from overdosing on a prescription opioid in 2016. That means about 19 women per day and about 27 men per day died from prescription opioid overdoses (NIDA 2020). Likewise, NIDA (2022) reports the same tendency that more males than females are likely to die from opioid overdoses, stating that nearly 20,000 females and 50,000 males died from overdose involving any opioids in 2020.

Young adults are not exempt from the opioid epidemic. According to Turning Point Centers (2022), in 2014, over 1,700 young adults (18-24 years of age) died from Rx drug overdose, which equals nearly 5 persons per day. Drug overdose death rates involving opioids among adolescents are also high. CDC (2017) reports that those rates among people ages 15-19 tripled from 1999 to 2007, although it declined from 2007 to 2014, and increased again in 2015. Ventura County also has a significant number of opioid overdose deaths. Ventura County Responds explains in “Fentanyl & Fake Pills” that more than 200 people in Ventura County die each year from opioid overdoses. COAST (2022) also states that 653 opioid-related deaths occurred in 2016-2021 and 269 accidental overdose deaths happened in 2021 in Ventura County.

Thus, it is important to focus on opioid use among young adults in Ventura County. In order to learn about how to educate and prevent misuse among this group we must first identify how they are getting access to opioids. One of the most common ways that adolescents gain access to opioids is through a prescription (Olufunmilola et al. 2022). It was found that 64 percent of clinicians do not have any protocol in prescribing pain medication which leads to misuse (Olufunmilola et al. 2022). The most common opioids prescribed to adolescents include oxycodone, hydrocodone, and codeine (Olufunmilola et al. 2022). Olufunmilola et al. (2022) also state that many of these doctors do not believe opioids can have a different effect on adolescents when compared to adults. They believe that there will not be any negative effects resulting from adolescents taking opioids. Yet research has shown that those who are prescribed opioids before the 12th grade are more likely to misuse, when compared to those without a prescription (Olufunmilola et al. 2022).

The second way in which adolescents gain access to opioids is through unsafe medication storage. A study found that 86.3 percent of opioid exposure happened within the household (Olufunmilola et al. 2022). Gaining access to opioids at home often leads adolescents to go on and share the opioids among their peers. It was reported that although parents believe that adolescents were more vulnerable to opioid overdose than adults, unsafe medication practices still happened. Parents were more likely to properly store medications from children under the age of seven than their adolescent children (Olufunmilola et al. 2022). This was due to this idea that they did not believe that their adolescents would misuse and share opioids. Other factors that contributed to the unsafe storage practice was the factor that parents did not know how to dispose of them, kept them for future use, or they believed that they had paid too much money to just dispose of them (Olufunmilola et al. 2022). 

There are numerous ways young adults and adolescents gain access to opioids as they become more easily attainable. It has been recorded that most adolescents obtain opioids from the streets, their parents, friends, and the internet. Some adolescents are able to draw distinctions between illicit drugs and prescription drugs. The growing popularity for prescription drugs reflects the misconception that prescription drugs are safer than street drugs (Friedman et al. 2006). A study of students enrolled in substance use recovery high schools found most adolescents are pressured by peer culture and often come from substance-using families (Russell et al. 2015). 

Some opioid users report gaining access to opioids through their friends and family members' medicine cabinets. Often times they abuse the drug with the one providing it. Illicit drugs can be found at high school and college parties including night clubs. In these cases, the drugs are consumed with others and sometimes due to social pressure. 

News reports are now becoming more common on young adults using and sometimes overdosing at schools. Every day, more reports of drugs being found on school properties are being reported indicating that the sale of opioids is taking place inside these schools. There are some cases in which young adults and adolescents are prescribed opioids for pain management by physicians. There exists limited guidance on opioid use in the pediatric population, leading to prescription safety concerns. The Pediatric Pharmacy Advocacy Group (PPAG) recommends pharmacists and doctors incorporate the use of electronic prescription drug–monitoring programs prior to prescribing opioids (Matson et al. 2019). Opioid misuse is unfortunately common among adolescents and young adults and is often associated with other substance abuse such as alcohol (Hudgins et. al).

For more information about opioids, overdose, safe medication disposal, and more visit the Ventura County Responds website.

References:

• Centers for Disease Control and Prevention. 2017. “Drug Overdose Deaths Among Adolescents Aged 15–19 in the United States: 1999–2015” Access date: November 25, 2022. https://www.cdc.gov/nchs/products/databriefs/db282.htm.
• Centers for Disease Control and Prevention. 2022. “Understanding the Opioid Overdose Epidemic.” June. https://www.cdc.gov/opioids/basics/epidemic.html#print.
• County Opioid Abuse Suppression Taskforce. “Addressing the Opioid Crisis in Ventura County.” Access date: November 20, 2022. https://www.coastventuracounty.org/.
• Friedman, Richard A., M.D. 2006. “The Changing Face of Teenage Drug Abuse - the Trend Toward Prescription Drugs.” The New England Journal of Medicine 354(14):1448-50 https://proquest.ezproxy.csuci.edu/login?url=https://www.proquest.com/scholarly-journals/changing-face-teenage-drug-abuse-trend-toward/docview/223934259/se-2.
• Hudgins, Joel D., John J. Porter, Michael C. Monuteaux, and Florence T. Bourgeois. 2019. “Prescription Opioid Use and Misuse among Adolescents and Young Adults in the United States: A National Survey Study.” PLoS Med 16(11): DOI: 10.1371/journal.pmed.1002922. 
• Matson, K. L., Johnson, P. N., Tran, V., Horton, E. R., & Sterner-Allison, J. 2019. “Opioid Use in Children.” The Journal of Pediatric Pharmacology and Therapeutics, 24(1): 72–75. https://meridian.allenpress.com/jppt/article-abstract/24/1/72/81985/Opioid-Use-in-Children.
• National Institute on Drug Abuse. 2020. “Substance Use in Women Research Report: Sex and Gender Differences in Substance Use.” April. https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use.  
• National Institute on Drug Abuse. 2022. “Overdose Death Rates.” January. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates.
• Olufunmilola Abraham, Tanvee Thakur, Kelsey Brasel, Derek Norton, Claire A. Rosenberger. 2022.”Development of the Adolescent Opioid Safety and Learning (AOSL) Scale Using Exploratory Factor Analysis.” Research in Social and Administrative Pharmacy, 18(5): 2796-2803. https://doi.org/10.1016/j.sapharm.2021.06.007.  
• Russell, B. S., Trudeau, J. J., & Leland, A. J. 2015. “Social influence on adolescent polysubstance use: The escalation to opioid use.” Substance Use & Misuse, 50(10): 1325–1331. https://www.tandfonline.com/doi/abs/10.3109/10826084.2015.1013128.   
• Saloner, Brendan, Emma E. McGinty, Leo Beletsky, Ricky Bluthenthal, Chris Beyrer, Michael Botticelli, and Susan G. Sherman, 2018. “A Public Health Strategy for the Opioid Crisis.” Public Health Reports, 133(1_suppl), 24S-34S. https://doi.org/10.1177/0033354918793627.  
• Substance Abuse and Mental Health Services Administration. 2020. “2019 NSDUH Annual National Report.” National Survey on Drug Use and Health. https://www.samhsa.gov/data/report/2019-nsduh-annual-national-report.
• Turning Point Centers. “Guide: Opioid Addiction Among Young Adults, Youths.” Access date: November 20, 2022. https://turningpointcenters.com/blog/guide-opioid-addiction-young-adults/.
• Ventura County Responds “Fentanyl & Fake Pills” Access date: November 25, 2022. https://www.venturacountyresponds.org/preventing-overdose/fentanyl-fake-pills.