One of the hottest topics in the news today is the opioid epidemic and how it is affecting households in America. From political campaigns to celebrity overdoses, the opioid crisis is no longer hidden. Whether these painkillers are obtained illegally from street dealers or prescribed by a health care professional, they are overused and causing an addiction crisis in our country.
The addiction industry is a billion dollar industry and is costing thousands of lives each year. “Opioid addiction is driving this epidemic, with 18,893 overdose deaths related to prescription pain relievers, and 10,574 overdose deaths related to heroin in 2014,” states the American Society of Addiction Medicine. “Of the 21.5 million Americans 12 or older that had a substance use disorder in 2014, 1.9 million had a substance use disorder involving prescription pain relievers and 586,000 had a substance use disorder involving heroin.”
A letter from the Surgeon General
Surgeon General Vivek H. Murthy recently released a nationwide warning to medical professionals asking for their help to curb this opioid epidemic. In this letter, Dr. Murthy addressed the need to screen patients for opioid misuse and educate patients on a step-up approach to pain management. Additionally, he acknowledged medicine’s past and how physicians at one time were taught to give opioids on a regular basis, as they were not considered addictive. This might make it difficult for older practicing physicians who have been prescribing these medications for years, as this is what they were taught in training.
“It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain,” according to Dr. Murthy’s warning.
A convoluted problem
Pain can truly hinder an individual’s life, and living pain free is a very important factor in a person’s overall happiness. Primary care physicians are faced with patients who are in pain on a daily basis, and often these patients are demanding the strongest painkillers on the market.
This puts physicians in a difficult spot, as many payment methods are now based on customer satisfaction. Although “do no harm” is the mainstay of medicine, it is also imperative that patients are happy. This is not a simple issue, but one that is convoluted, involving determined patients and overworked physicians, who are often not allotted enough time to adequately counsel the patients on pain management.
So how can we fix this?
As patients, it is imperative to listen to your doctors and respect their decisions. They went through years of school and training, and are there to guide you. Ask questions to be informed, but allow your doctor to make the proper treatment plan for you.
As physicians, we must do our due diligence to take a moment and use the statewide opioid database to look up every patient when prescribing opioids to someone for the first time. Also, take the time to gather all the pertinent history and prescribe other treatment options for mild and moderate pain. For severe pain, use the step-up ladder approach for prescribing opioids and start with the minimum dose for a short duration. Take time to always screen and counsel patients for potential opioid dependence and addiction. If you feel that there may be an addiction at hand, always refer to a pain management specialist.
This opioid epidemic has been ongoing for years, and there is no quick fix. Rather, it will take time and diligence among patients, politicians, physicians, pharmacists and the pharmaceutical companies alike. This is a system-wide problem and everyone can make an effort to do their part and take the pledge.
Sovereign Health is a leading behavioral health treatment provider with locations across the United States. We treat mental health disorders and substance abuse, including prescription drug and opioid addiction and dependence, as well as co-occurring conditions. For more information, please call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at Sovereign Health and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.