The Opioid Epidemic: A Toxicology Report
Article overview: The United States has paid a heavy toll for the nation’s opioid epidemic. Opioid-related deaths have placed a heavy burden on the country and one of the hidden impacts of this crisis is how it affects American pathologists across the United States.
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The United States has paid a heavy toll for the nation’s opioid epidemic. Opioid-related deaths have placed a heavy burden on the country and one of the hidden impacts of this crisis is how it affects American pathologists across the United States.
The Opioid Epidemic
From 2001-2016, opioid-related deaths increased 292% – approximately 1.68 million people died in 2016 alone. The most affected age range was people 24-35-years old. Prescription opioids are currently one of the leading health concerns in North America, yet the true burden hasn’t been defined.
Both famous and everyday people are victims of the epidemic. The media focuses more on celebrity deaths than anyone else. However, it’s the everyday contractor with the occupational injury or the student-athlete who needs narcotics after surgery that are examples of the typical patients’ physicians treat.
Doctors routinely prescribe opioids for people seeking help for pain. Opioids were approved for use as analgesia nearly 70 years ago, but it wasn’t until the last two decades that researchers, patient advocates, and physicians raised concerns over their safety.
Opioid-Related Deaths and Their Effects on Pathologists and Society
Every year pathologists see a variety of deaths related to opioids such as overdoses and fatal accidents. Frequently, coroners find that it is more than one drug that kills someone, or they’ve consumed alcohol with their opioids. Opioids also increase the risk factors for many health issues that people already have.
For pathologists who are overwhelmed with their caseload, to begin with, the increase in opioid deaths adds more stress to a system already failing. States and localities don’t have the money to hire additional pathologists to handle the workload. As a result, they’re performing fewer autopsies and completing external exams instead. Worse still, forensic pathologists are facing burnout causing them to move to other specialties or quit.
There are approximately half of the pathologists needed to work the current caseload, and it’s prompted a public accountability crisis. Families of the victims’ question whether a complete forensic investigation was performed on their loved one.
When Should a Forensic Pathologist Perform an Autopsy?
Autopsies should be performed regularly on overdose victims because often pathologists find a different cause of death when they use the scalpel. A toxicology report may show a fatal dose of a narcotic, but a careful investigation may indicate that the patient was following their doctor’s orders and not abusing the medication.
An autopsy could show that something such as heart disease caused the patient to die suddenly. Without an autopsy, toxicologists and pathologists can assign an incorrect cause of death to the case. Many pathologists know to perform autopsies on suspected overdoses because often the cause of death is some type of accident resulting from the abuse of opioids.
What is the Solution?
Unfortunately, the government hasn’t invested enough money into the battle against the American opioid epidemic. They are aware that the problem exists, but no one has allocated the funds to match this highly politicized issue. There are excellent plans to research other pain treatments and distribute emergency injections such as Narcan, but the funds put forth don’t match the needs of this country.
A multi-faceted approach is necessary that includes the physicians prescribing opioids, funds for complete drug rehabilitation programs, and increases the budgets of first responders, pathologists, and other professionals on the front-lines of this battle. Those seeking to become a forensic toxicologist, pathologist, police officer, firefighter, or rescue personnel should understand the true nature of those career choices today.
Extensive research needs to focus on different pain treatment methods. Physicians must advocate for their patients and not pharmaceutical companies. Only a combined effort will beat the opioid problem in the United States.
Related reading: For related context, read New Drug-Testing Protocols: A Forensic Toxicologist’s Analysis, How Drug-Testing Laboratories Preserve Sample Integrity, DUI Alcohol Testing: Methods, Accuracy and Limitations. Browse the Forensic Toxicology topic hub.
