One statistic illustrates the grim reality of opioid abuse -- and it's just the beginning

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Opioids have become a deadly epidemic in the U.S. — and a new study begins to show just how dire the situation has become. According to a new paper by FAIR Health, there's been an over 3,000% increase in opioid dependency between 2007 and 2014 among the privately insured.

To conduct their study, researchers pooled insurance records for some 150 million patients, tracking certain "diagnosis codes" that reflected opioid dependency — a condition marked by "by symptoms such as increased tolerance, withdrawal or unsuccessful attempts to quit," according to CNN.

The more than 3,000% increase is "a shocking figure," John Merrigan, register of the Franklin County Probate and Family Court in Massachusetts and co-chair and founder of the Opioid Task Force, said in a phone interview Tuesday.

But the reality could be even more grim: "I don't even think that's the tip of the iceberg," he said.

But the widespread study offers only a narrow view into a much larger problem. That's evident in one of the paper's more striking takeaways: The medical records of millennials — people 19 to 35 — showed the highest incidence of opioid dependence.

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Opioid painkillers capitalize on our body's natural pain-relief system. We all have a series of naturally produced keys ("ligands") and keyholes ("receptors") that fit together to switch on our brain's natural reward system — it's the reason we feel good when we eat a good meal or have sex, for example. But opioids mimic the natural keys in our brain — yes, we all have natural opioids! When they click in, we can feel an overwhelming sense of euphoria.

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Opioid painkillers can have effects similar to heroin and morphine, especially when taken in ways other than prescribed by a doctor.

When prescription painkillers act on our brain's pleasure and reward centers, they can make us feel good. More importantly, though, they can work to reinforce behavior, which in some people can trigger a repeated desire to use.

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You may also feel sleepy.

Opioids act on multiple brain regions, but when they go to work in the locus ceruleus, a brain region involved in alertness, they can make us sleepy. Why? The drugs essentially put the brakes on the production of a chemical called norepinephrine, which plays a role in arousal.

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Your skin may feel flushed and warm.

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You'll begin to feel their effects 10 to 90 minutes after use, depending on whether they're taken as directed or used in more dangerous ways.

Some drugmakers design versions of their medications to deter abuse. Extended-release forms of oxycodone, for example, are designed to release slowly when taken as directed. But crushing, snorting, or injecting the drugs can hasten their effects.

It can also be deadly. Between 2000 and 2014, nearly half a million Americans died from overdoses involving opioid painkillers and heroin, a report from the US Centers for Disease Control and Prevention found. The most commonly prescribed painkillers were involved in more overdose deaths than any other type of the drug.

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Your breathing will slow as well.

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Depending on the method used, the effect can last anywhere from four to 12 hours.

For severe pain, doctors typically prescribe opioid painkillers like morphine for a period of four to 12 hours, according to the Mayo Clinic. Because of their risks, it's important to take prescription painkillers only according to your physician's specific instructions.

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Overdosing can stop breathing and cause brain damage, coma, or even death.

2014 report from the American Academy of Neurology estimates that more than 100,000 Americans have died from prescribed opioids since the late 1990s. Those at highest risk include people between 35 and 54, the report found, and deaths for this age group have exceeded deaths from firearms and car crashes.

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Combining them with alcohol or other drugs — even when taken according to the directions — can be especially deadly.

Since they slow breathing, combining opioid painkillers with other drugs with similar effects can drastically raise the chances of accidental overdose and death.

Yet they're often prescribed together anyway, according to the National Institute on Drug Abuse. "Unfortunately, too many patients are still co-prescribed opioid pain relievers and benzodiazepines [tranquilizers]," the institute said. In 2011, 31% of prescription opioid-related overdose deaths involved these drugs.

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Abusing opioid painkillers has been linked with abusing similar drugs, like heroin.

A CDC report found that people who'd abused opioid painkillers were 40 times as likely to abuse heroin compared with people who'd never abused them. The National Institute on Drug Abuse says that close to half of young people surveyed in three recent studies who'd injected heroin said they'd abused prescription painkillers before they started using heroin.

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You may also develop a tolerance for the drugs so that you need more to get the same effect over time.

Tolerance to opioid painkillers happens when the brain cells with opioid receptors — the keyholes where the opioids fit — become less responsive to the opioid stimulation over time. Scientists think that this may play a powerful role in addiction.

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Suddenly stopping the drugs can result in withdrawal symptoms like shakiness, vomiting, and diarrhea.

Taking prescription painkillers for an extended period increases the likelihood that your brain will adapt to them by making less of its own natural opioids. So when you stop taking the drugs, you can feel pretty miserable. For most people, this is uncomfortable but temporary.

But in people who are vulnerable to addiction, it can be dangerous because it can spurn repeated use.

"From a clinical standpoint, opioid withdrawal is one of the most powerful factors driving opioid dependence and addictive behaviors," Yale psychiatrists Thomas Kosten and Tony George write in a 2002 paper in the Journal of Addiction Science & Clinical Practice.

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But many millennials are uninsured, or shy away from visiting the doctor because of the hefty price tags. If the health care system is one in which young people play a small role, their outsized representation in the study could point to a staggering number of millennials nationwide who are hooked on opioids.

Young adults between the ages of 18 and 25 are "the biggest abusers" of opioid pain relievers, according to the National Institute on Drug Abuse. But it's more than just painkillers; white millennials, in particular, also seem to be fueling the heroin epidemic.

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"Percocet," according to Merrigan, is "past tense. The problem is, we're seeing young people going straight to heroin. There's no gateway drug, there's no marijuana or cigarettes, they're going straight to heroin."

Yet heroin use isn't something insurance records can necessarily speak to. The records can highlight repeat opioid refills and spotlight telltale habits, like frequent trips to the doctor and lab testing. But heroin isn't a drug doctors prescribe.

The opioid crisis, on the whole, isn't confined within doctors' offices, Merrigan stressed. The drugs "penetrate the system at every level, whether it's the criminal justice system [or] whether it's the medical system." The paper explores one facet of a multi-faceted crisis from a single angle only — and it may leave a lot of people out in the process.

Another troubling point: Behind the staggering statistics are real human casualties, Dr. Michael Smith, medical director and chief medical editor of WebMD, pointed out. Deaths from prescription painkiller overdoses increased 400% among women and 265% among men between 1999 and 2013, according to the Centers for Disease Control and Prevention.

"The more troubling point about all this is what underlies this 3,000% is all the costs and the hospitalizations and the illness and the deaths that are part of that 3,000%," Smith said. Opioid use in the U.S. has only recently garnered attention as an epidemic. The casualties, he suggested, will likely continue to mount while we play catch-up.

While the government has taken certain steps to reign in pain pill overprescription — likeupdating drug labelsand passing legislation that helps authorities help people with addiction — it's fallen "behind the curve" by about three years when it comes to controlling the crisis, Merrigan said. And it's going to get worse before it begins to get better.

"We're still in the early stages of fighting this," Merrigan said, "so that 3,000% increase could be 6,000% in a couple years."

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