A new study by the Taub Center shows that the rate of consumption of opioids (prescription narcotic pain medication) in Israel has hit new highs and Israel is now ranked in first place in the world for opioid consumption. Among the opioids used is fentanyl which is 50 times stronger than heroin.
The study conducted by Prof. Nadav Davidovitch, Dr. Yannai Kranzler, and Oren Miron presents worrying data on the use of prescription pain medications and their destructive influence. It notes that increased consumption is primarily among the young, healthy individuals, and those who are living in poverty.
In the United States, where the phenomenon has reached epidemic proportions, a report from 2021 showed that about 80,000 deaths per year were attributable to opioid abuse. Israel has not reached this level, but since the number of autopsies performed is exceptionally low due to religious restrictions, it is hard to identify deaths that have resulted from opioid abuse and to recognize the signs of an approaching epidemic.
The negative side effects of opioid abuse include drowsiness, confusion, nausea, constipation, and serious respiratory depression that can be life threatening. Opioid use over time causes the body to develop a tolerance, and so a need for increasing dosages develops quite quickly. The absence of appropriate alternatives in the health system and a supportive social network can lead to abuse and a search for illicit drugs with the added risk of overdose and death. On the other hand, coming off of opioids must be done under supervision to avoid difficult withdrawal symptoms.
The researchers delineate a number of steps that can protect those most vulnerable for addiction and opioid abuse:
- Improved supervision of prescriptions for opioids and of the negative effects from their use, like addiction and overdose, including publishing data related to their use.
- Increasing the number of autopsies in cases of suspected overdoses and the establishment of a committee to examine cause of death. Israel has an advantage over the United States in the supervision of prescriptions and the accessibility to patient medical history and it is important to use this advantage to prevent addiction.
- Developing best practice for safely prescribing opioids, including appropriate alternatives for fentanyl and other opium-based medications, particularly among high-risk patients, and implementation including publicity and cooperation between medical agencies and educational facilities.
- Updating patients and their families at the time the medication is prescribed regarding the dangers of addiction, and follow-up with patients in the health funds during their prescription period.
- Patient management that considers the necessary conditions for the restoration of patient health – mental health needs and other needs like nutritional security, family support, and stable living conditions. To this end, it is recommended to establish a support system dedicated to trauma treatment and social instability that can stem from addiction, opioid abuse, and overdose.
- Increasing accessibility to a variety of medical interventions for addiction and services that serve to limit the damage of opioid abuse.
Prof. Davidovitch, one of the study’s authors, says that there is a need to develop an integrated program on the national level that includes the steps outlined above, alongside increased public awareness of the risks of opioid abuse and addiction and the encouragement of the use of non-addictive alternatives. He believes that only in this way can we succeed in limiting the destructive effects of the rise in opioid use and deaths from overdose and give the best care to those in need.