|Type of paper:||Research paper|
Amid intense discourses over opioid abuse problems, chronic pain patients are often overlooked despite the need for them to use these drugs regularly. Opioids are drugs that impede transmission of nerve impulses. They range from illegal substances such as heroin to lawfully prescribed pills such as morphine, codeine and oxycodone (National Institute on Drug Abuse, n.d.). Physicians recommend that individuals suffering from prolonged soreness should take these drugs, a situation that eventually results in dependency since they need the opioids to subdue their condition. However, from an ethical dimension, a thin line separates dependence and addiction with both of them instigating the development of withdrawal symptoms associated with substance overuse. Moreover, some people end up overdosing due to their insatiable craving for ingesting these prescriptions putting them at risk of death. For that reason, this essay attempts to shed light on the need to ban the prescription of opioids due to their ultimate deleterious implications on its users regardless of whether they are taken as stimulants or medications.
(Smith, paragraph 1) states that the United States is experiencing an opioid crunch characterized by a rising mortality rate due to heroin overdose and medicinal usage. In 2014, there were 19000 death cases reported in the country caused by these drugs. (Lopez, paragraph 2) stipulates that almost 64000 individuals perished in 2016 due to substance abuse, where heroin and fentanyl were among the synthetic opioids that topped the list of these demises' causes. Such figures represent a higher annual death toll compared to HIV/AIDS, firearm violence and road accidents. Furthermore, between 2015 and 2016, this opioid epidemic was culpable for a drop in the average American's life expectancy by two years, which was the highest margin recorded in about five decades (Lopez, paragraph 3).
This disaster has been brewing since the 1990s when clinicians recognized the discomforts associated with long-lasting pain. Pharmaceutical organizations took advantage of this opening by urging doctors to prescribe opioids as painkillers through deceptive marketing about the effectiveness and health safety of these drugs Since then, the US has espoused opioids as pain remedies to an extent that the country currently leads globally with regards to opioids consumption, with about 5.2million Americans estimated to use these drugs on a daily basis (Lopez, paragraph 11).
Sykes and Thorns (313) acknowledge that inapt increase in opioid dosages sparks delirium, hallucinations and myoclonus. Additionally, respiratory depressions can also occur due to excessive intake of strong opioids even though this outcome will be experienced during later stages of prolonged use. Vuong et al., (113) studied the effects of morphine and opioids on the endocrine structures and revealed that protracted use of these pills hampered female sexual development at the prenatal and pre-pubertal stages. Women consuming morphine perinatally exhibit interrupted menstrual cycles as well as low levels of plasma estradiol. However, in men, the obstruction of sexual processes seem to be less pronounced since testicular weight and testosterone levels are similar for both opioids' users and non-users.
Despite these potential disasters associated with inappropriate use of these doses, doctors are still attributed to the rising prevalence of opioid addiction due to their willingness in administering them to patients. In as much as these medications provide a solution to the acute pain concern, some doctors misappropriate these opioids by prescribing excess dosages such as weeks or months-long treatments when only days-long doses would be enough (Lopez, paragraph 17). The eventual outcome is that patients are left with surplus pills at their disposal since the physicians may have opted to take "precautions" to prevent complaints from their patients.
Nonetheless, regardless of the undesirable effects of these substances indicated in the paragraphs above, the concept of double effect annuls such negative reasoning by maintaining that opioids are safe pain-relieving remedies that do not accelerate the chances of death of patients under palliative treatment. Good, Ravenscroft and Cavenagh (514) researched the implications of sedatives and morphine on the continued existence of Australian acute pain victims and discovered that these portions did not shorten these patient's lives. Interestingly, in this study, those patients who received above 300mg of haloperidol and benzodiazepines per day portrayed an increased survival compared to those taking less than 300mg of these painkillers. Doctors are likely to use this double effect in presenting an ethical rationale for administering opioids on grounds that this prescription is potentially valuable although it may impose damaging repercussions, the deleterious effects are not necessarily meant to realize the positive outcomes and that the clinician's intentions target achieving the beneficial effects while taking into account possible adversities (Sykes $ Thorns, 312). For that reason, such validations give physicians some level of confidence in the efficiency and safety of opioids when purposely used in treating palliative patients and depending on the pain symptoms observed.
Nonetheless, irrespective of their awareness of the principles of double effect, doctors still continue to prescribe inappropriate dosages to chronic pain sufferers resulting in the high fatalities caused by cases of overdose or addiction. Therefore, the use of opioids should be barred completely to avoid the risk of non-compliant doctors wrongly administering these drugs in the name of playing safe when handling their patients. Moreover, more stringent penalties should be implemented on people caught trafficking or using illegalized opioids such as heroin. By so doing, the detrimental implications of these drugs, as seen in the discussion above, will be effectively eliminated.
Good, Phillip D., Peter J. Ravenscroft, and John Cavenagh. "Effects of opioids and sedatives on survival in an Australian inpatient palliative care population." Internal medicine journal35.9 (2005): 512-517.
Lopez, German. "The Opioid Epidemic, Explained". Vox, 2017, https://www.vox.com/science-and-health/2017/8/3/16079772/opioid-epidemic-drug-overdoses. Accessed 8 May 2018.
National Institute on Drug Abuse. "Opioids- Brief Description". Drugabuse.Gov, https://www.drugabuse.gov/drugs-abuse/opioids. Accessed 8 May 2018.Smith, SE. "War On Prescription Drugs: What If You Depend On Opioids To Live A Decent Life?". The Guardian, 2016, https://www.theguardian.com/us-news/2016/jul/12/prescription-drugs-what-if-you-depend-on-opioids-chronic-pain. Accessed 8 May 2018.
Sykes, Nigel, and Andrew Thorns. "The use of opioids and sedatives at the end of life." The lancet oncology 4.5 (2003): 312-318.
Vuong, Cassidy, et al. "The effects of opioids and opioid analogs on animal and human endocrine systems." Endocrine reviews 31.1 (2009): 98-132.
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