Strategies to address opioid abuse and overdoses have had limited effectiveness in mitigating the high rate of emergency room visits and mortality due to this growing opioid epidemic. A multi-level approach to the opioid epidemic appears necessary to include access, education, prevention, early identification, and mitigation of this scourge, but more importantly we need an evidence-based approach. Prescription monitoring programs may identify patients using opioids and physicians prescribing them, but will not address sources of drugs through other channels.
Studies have shown a near-linear relationship and steady increase from overdose deaths representing a small but quickly growing number of patients with addiction subject to increasing opioid use with tolerance eventually reaching fatal levels. Emergency room visits for opioid overdoses occur at over 30 times the rate of fatal overdoses, suggesting the tip of this iceberg. The straight-line increases leading to overdoses make any proportion of this number grow over time until we can make an impact in the number of people exposed to opioids or mitigate the percent and rate at which they progress to abuse resulting in deaths.