Drug overdoses are now the leading cause of death among Americans under 50. The major contributor to this immense and growing public health crisis? Opioid addiction. As the opioid epidemic continues to destroy lives, it is also taking a toll on the U.S. economy.
A recent Princeton University study found that one in five American men leave the workforce for some time due to opioids. Nearly 13 percent of the total workforce in the United States experienced a two-week loss in productivity because of pain from injuries or surgery. And the estimated impact of abuse of opioids used to manage that post-surgical or non-surgical injury acute pain is more than $193 billion annually in lost work productivity and healthcare costs. Clearly, we need a more effective and less risky approach to pain management.
About 1.9 million Americans are addicted to opioids. Between 78 and 91 die every day from an opioid overdose, and about half of these deaths are related to prescription opioids. In 2000, there were two overdose deaths per 100,000 people related to the prescription of an opioid. By 2015, that figure had leaped five-fold.
Initiatives have been undertaken to address the issue, including state mandates, CDC prescribing guidelines, prescriber training programs, label changes imposed by the FDA to highlight long-term safety issues and IT solutions to monitor the amount of opioid prescriptions written by physicians. The FDA has even approved ten new opioids with abuse-deterrent properties – though many experts note that there are ways for patients to get around the deterrence.
Nevertheless, the epidemic shows no signs of abating; opioids remain the leading prescription treatment for post-surgical and non-surgical injury acute pain. Considering that there are nearly 70 million surgeries performed annually in the United States – not to mention sports injuries like rotator cuff partial tears or the various pains that afflict an aging population – effective pain management is obviously essential. We cannot just leave people to suffer through debilitating pain. At the same time, we need treatments that do not expose them to the danger of addiction.
The wave of the future for pain management includes effective, non-opioid and non-addicting solutions. And the answer may be in neurotoxin therapy. Neurotoxins have taken the medical world by storm, treating everything from migraines and depression to excessive sweating and neck spasms. Now, it’s time they step in to help solve the opioid crisis.
With botulinum neurotoxin serotype E (BoNT/E) therapy, this is becoming a possibility. Currently undergoing FDA-sanctioned clinical trials, BoNT/E has the same mechanism of action as botulinum neurotoxin serotype A (BoNT/A) products such as Botox®, but works much faster – it takes effect in less than one day, as opposed to three to seven days with Botox. Because of BoNT/E’s fast-acting nature, neurotoxin therapy can become a viable solution for musculoskeletal pain management.
Unlike opioids, which simply mask the pain and its symptoms, this neurotoxin therapy can treat a root cause of pain. The fast-acting neurotoxin does not cause drowsiness, dizziness or gastrointestinal side effects such as constipation – all contributors to increased hospital stays or reduction of work productivity. Perhaps most importantly, though, it offers an effective pain relief alternative at a time when opioid addiction has reached epidemic proportions.
While systemic opioids mask pain symptoms by blocking nerve signals to the brain, a localized neurotoxin treatment can block the release of acetylcholine, a chemical that causes the muscle hyperactivity and spasms that cause the pain in the first place. An injection could typically relax the muscles in less than 24 hours to reduce or eliminate pain. Furthermore, the effects wear off as the pain dissipates – within two to four weeks. Many people who have undergone a surgical procedure will, therefore, be able to reenter the workforce almost immediately without the risk of developing an opioid addiction.
As physicians and government agencies work to address the devastating human and financial costs of the opioid epidemic, they must look to medical innovations to provide safer, more effective pain management solutions.