A Timely Account of Addressing the Opioid Epidemic

(DGIwire) – As the opioid epidemic continues to rage, we at ReviewLoft have come to enjoy learning about various strategies for addressing it. That’s why we were intrigued when we began reading Heroin Death: How to Stop the Opioid Crisis by Joseph C. Mancini, MD. Mancini offers a stark but informative history of the opioid epidemic and what is being attempted to curb its effects.

One of Mancini’s most interesting topics is the potentially beneficial role of the drug buprenorphine, first synthesized in 1969. Unlike many other substances, writes Mancini, buprenorphine can be prescribed for pain relief to prevent opioid dependence in the first place, and prescribed at a higher dose for the treatment of those already addicted to opioids.

According to Mancini, buprenorphine has several properties that could make it a responsible choice during the opioid epidemic. Mancini notes several studies that describe buprenorphine’s “ceiling effect,” as a partial agonist, meaning it may have unique potential as a pain reliever without the risk of respiratory depression and consequent overdose death, in contrast to morphine and all the other full agonists.

These advantages and others, writes the author, have made it a key player in the fight to mitigate the opioid crisis brought on by overprescribing of opioid painkillers—a long and sad story that Mancini excellently summarizes in these pages.

Yet according to one study that Mancini describes, out of the nearly one million physicians in the United States, fewer than 20,000 have become certified to prescribe buprenorphine for the treatment of opioid dependence, while approximately 5,000 are actually responsible for the vast majority of those prescribing the medication. This, he writes, may be due in part to the misconception that the medication is too complex to prescribe. Therefore, in his book Mancini encourages anyone who is affected by the opioid crisis to learn more about medication-assisted-treatment and buprenorphine as an option for addiction and pain.

Mancini discusses strategies for combating the opioid epidemic, such as an increase of the awareness and access of naloxone to the levels that CPR and automated external defibrillators (AED) have reached. He also suggests the need for an increased awareness of low-dose buccal buprenorphine for the treatment of pain to prevent the downward spiral from even starting in the first place. Despite the availability of these important options, they are incomprehensibly underutilized.

Overall, we at ReviewLoft came away from Mancini’s book with a much better picture of the opioid crisis and how urgent it is to continue fighting it. We strongly recommend the book to anyone who wants to learn more about the crisis today.

ReviewLoft purchased its own copy of Heroin Death. It is available on Amazon.