PhUSE Day 1 – Keynote presentation from Dr. Mitra Ahadpour
Dr Mitra Ahadpour, FDA, PhUSE Keynote
AJ de Montjoie reflects on the PhUSE Keynote and the harsh realities of the opioid addiction crisis around the globe.
Terrifying Statistics
When a keynote presentation starts with shocking statistics, you know it’s going to be pulling on your emotional heartstrings. Here’s a couple of the openers from Dr. Ahadpour:
- 471,000 opioid prescriptions are dispensed every DAY in the US
- 130 people a DAY die of an opioid related overdose in the US
- 3/4 of people who take heroine started with prescription opioids
It was a disturbing start but it would not be fair to exclude the rest of the world from the issues with the opioid crisis. Indeed S-cubed’s home countries of Denmark and the UK are seeing the same increase in the problem. However, this may not be the complete picture, in fact there is no single source of data relating to the current state of opioid use and abuse. It means that making predictions about trends and developments in substance abuse are slow and often behind events. Equally, it’s no good assuming that only one sector of society is affected; all ethnic groups, all genders, all walks of life are affected.
Why do people use opioids and where is the treatment?
Of course, it’s easy to assume that it’s all down to doctors prescribing opioids that causes the issue in the first place. People are prescribed opioids to alleviate physical pain. But that’s not where many people are getting their opioids once the drug is no longer prescribed. The main source is from friends and family who have drugs sitting in their bathroom cabinet and hand them on. Dentists also prescribe them for pain (particularly for wisdom tooth removal) and in the US, 1.2 million 10 – 19 year olds were given opioid pain relief where often other medication would have been adequate. It’s terrifying to then relate that back to the statistics about heroine presented at the start of the talk.
Bearing in mind the complex challenges of addiction, you would expect that a society would be helping people who are suffering to get into some kind of support programme but only 20% of people in the US get help and treatment. The top reason for not getting help … people don’t want to stop, essentially they’re not ready. The second reason: they have no healthcare coverage to get treatment. When you live and work in countries with socialised medicine, you really do value what you have, especially when confronted by a system, where if you can’t pay, you are left to suffer.
Suffer the children
Behind the person who has the substance abuse disorder are many other victims. Shockingly children are the ones who find a parent dying or are living with the consequences of their parent’s illness. Children are often forgotten in any treatment programme. 20% of foster care placements in the US are due to substance abuse; that’s 100,000 children. Currently, 8.7 million children in the US have at least one parent who has substance abuse disorder. It’s at this point that silence descended across the room and there was a collective intake of breath.
Prevention is better than a cure
How to prevent people getting to the point of addiction seems to be the most important area of work. When new patients are exposed to opioids they need to know the benefits and the risks to their health. It’s interesting but having been in a dentist’s chair and through surgery in the UK, I have never once been offered any opioid pain relief. In fact, even when I was having my teeth and mouth pulled around as an adult for my braces (some of us are glutton for punishment for a smile), the most I was offered was paracetamol despite excruciating pain! Dr Ahadpour spoke about improving pain management programmes and that surely has to be the goal and understanding that perhaps looking at other pain relief is good way forward.
One of the more surprising revelations was the use of e-cigarettes in adolescents and the lack of understanding about the nicotine content in these devices. 1.5 million American teenagers are now vaping. They are then more likely to move onto other tobacco products and a small percentage will then go on to try other substances.
Hope for the future
The presentation ended on the positive. There is hope for future. The view of addiction is changing and the world is starting to realise we have to treat it like any other chronic disease. You wouldn’t turn someone with diabetes away because they relapsed on their diet and this needs to be extended for those suffering from chronic substance abuse disorder. But it’s a collect responsibility and there is a hope that our community of pharmaceutical and biotech professionals can contribute to better outcomes and a preventative regime.
Individually we are a drop, together we are an ocean – Ryunosuke Satoro