The pain remained measured as an inevitable sensory response to tissue damage until the 1960s, and it is probably the most common symptomatic reason to seek medical consultation. They are classified into two categories, i.e., acute and chronic pain. Acute pain is short-lived, however severe. Whereas chronic pain results from a disease, it could be mild to severe and lasts for a longer duration. Chronic pain requires management, and the most commonly used and effective analgesic treatments for severe pain are opioids. Opioids include medicines such as morphine, fentanyl, and tramadol.

In the 1970s and 1980s, the efficacy of opioids to treat illness was enormously enriched by advancements in modern medicinal chemistry and neuroscience. Today, opioids remain the mainstay of analgesic treatment for severe acute, perioperative, and chronic pain.

Unfortunately, higher or overdoses of opioids can decrease heart and respiratory rate to dangerous levels, leading to death. Also, it can cause numerous detrimental effects, including analgesic tolerance, paradoxical hyperalgesia, nausea and vomiting, constipation, respiratory depression, and transition to addiction.

The term “opioids” includes compounds extracted from the poppy seed and semisynthetic and synthetic compounds with similar properties that can interact with opioid receptors in the brain. The side effects of opioids overdose dramatically affect the quality of life of patients.

Most people dependent on opioids used illegally cultivated and manufactured heroin, but the proportion of prescription opioids is growing. The plausibility of emerging an opioid use disorder depends on many factors, including the length of time a person is prescribed to take opioids for acute pain and the length of time people continue taking opioids (whether prescribed or misused).

According to the United Nations Office on Drugs and Crime, almost 12 million years were estimated loss of “healthy” life resulting in premature death and disability attributable to global opioid abuse just in 2015. WHO estimates, in 2017 itself, nearly 115 000 people died of opioid overdose.

Opioid abuse has been a global threat for centuries, but the proliferation of synthetic opioids and their use within this current decade have created epidemic-level harm in some countries. Lately, when the COVID-19 pandemic rampaged the world, the US has entered into a dangerous opioid epidemic. In the US, drug racketeers have repeatedly misused opioids and pirated them; addiction to opioids, including synthetic opioids, is a severe public health crisis that also affects social and economic well-being.

The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including healthcare costs, lost productivity, addiction treatment, and criminal justice involvement.

As seen all over the history of medicine, science can be an essential part of resolving such a public health crisis. Rising mortality due to opioids overdose can be preventable if the person receives essential life support and administration of the drug naloxone. It is considered as an antidote to opioids overdose if administered in time.

A few Countries made naloxone available in pharmacies without prescription though access to the drug is generally limited to health professionals in many countries. Worldwide, health organizations are discovering new and better ways to prevent opioid misuse, innovative medications to treat opioid use disorders, and non-addictive strategies to manage pain.

Opioids evolution or revolution?
By Benzeer Siddique, Health Economist, Sanrachana