The Opioid Crisis: Don’t Punish The Patients

By Susan Kuebler

Far too often, when facing a crisis, there is a tendency to throw the baby out with the bathwater.  For many people, especially those who suffer from chronic pain, that appears to be the answer to the current crisis where people who have become dependent on opioids have gone on to heroin use when their prescription medication is no longer available.

Yes, there has been abuse of the class of drugs known as opioids, most commonly Vidodin (hydrocodone) and Percocet (oxycodone).  They are synthetic versions of opiates such as heroin and morphine and were originally considered to be less addictive.

However, people who have been prescribed these drugs for pain have used and misused them, becoming hopelessly addicted.  When their supply is suddenly cut off, they then resort to heroin as a cheap and easily obtained alternative.  This, in turn, has lead to an alarming number of overdose deaths due to heroin.

For some the answer is simple.  Don’t use opioids.  That was the President’s response yesterday when he declared the opioid epidemic a “public health emergency.”  In words reminiscent of Nancy Reagan’s “Just Say No” campaign on drugs, he said “If we can teach young people, and people generally, not to start, it’s really, really easy not to take ’em.”  He even compared it to his own brother’s fight against alcoholism.

Once again, President Dim Wit shows his complete misunderstanding of what has become a national crisis.  The people who become addicted to opioids don’t start by purchasing them from shady dealers on street corners.  They are prescribed them by their doctors.  He also promised to remove a “really bad” drug from the market, not knowing that this drug had been withdrawn from the market back in June.

But here is a different take on the crisis.  The problem is not the patients.  The problem is not the pharmaceutical companies.  The problem is the doctors and the FDA.  Let’s look at what happens if you go to a responsible pain management specialist for treatment.  You are required to sign a document that comes just short of promising to turn over your first-born child if you violate their terms.

  • If you obtain pain medication from another doctor, you will be terminated as a patient.
  • If you do not fill ALL your prescriptions at the same pharmacy, you will be terminated as a patient.
  • If you use any illicit drugs, you will be terminated as a patient. And patients are routinely screened.

If these rules were followed by all medical professionals, the opioid crisis might be limited.

Patients who become addicted to opioids do so because they are able to obtain pain medication from more than one doctor.  And any qualified medical doctor may prescribe any medication for any reason whatsoever.  They are not limited to the “approved indications” by the FDA for what they can prescribe.  If one is limited to obtaining pain medication ONLY from a qualified pain management specialist, the number of patients abusing the drugs would decrease.  Patients who receive pain medication from their dentist would have 24 hours to notify their pain management specialist of their prescription.

Only certain pharmacies would be allowed to fill prescriptions for pain medication and they would have a link to all other pharmacies in the United States with similar privileges.  Any attempts to fill multiple prescriptions for pain medication would be quickly identified and stopped.

Routine testing for illicit drugs is not unusual for many medical professionals, including psychiatrists.  But there is new information that should be shared and the medical community needs to support this.  The use of marijuana has been shown to significantly reduce pain in many patients, eliminating the need for opioid medications.  Despite the 1950 mindset of our current Attorney General, marijuana is not a gateway drug for harder drugs.  Or not any more than the legal use of alcohol.

These are all preventive measures and the crisis for the thousands of people now addicted to heroin needs to be addressed.  Once again, Trump fall short of the mark.  By declaring this a “public health emergency” instead of a “national health emergency” Trump shortchanges the American people.  This declaration makes no additional federal funds available to fight the problem and will end after 90 days.

The answer to the crisis is not to prohibit the prescription of opioid pain medication or to limit them to a short period of time.  The only people who will suffer from this, and they will truly suffer, are legitimate chronic pain patients.  In fact, this will only exacerbate the crisis as these people will be forced to seek alternative, and probably illegal, sources of pain relief.  Or, in the direst situations, seek a permanent end to their pain.

This is a complex situation that requires a multi-pronged solution.  But please, don’t throw the baby out with the bathwater in a quick-fix answer.

"All shall be well and all shall be well and all manner of things shall be well". Julian of Norwich.

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