The Opioid Crisis and Healthcare- What a Practitioner Must Know and Do
by Dr. Keith H. Taylor
According to the 2017 Surveillance Report published by the Centers for Disease Control (CDC), 1 in every 50 individuals in America had at least one prescription (Rx) for opioids filled or refilled in 2016. Every day, more than 90 Americans die after overdosing on opioids. The misuse of and addiction to opioids including prescription pain relievers, heroin, and synthetic opioids such as fentanyl is a serious national health crisis that affects public health as well as social and economic welfare. It is not uncommon to see fentanyl rings busted on the news and federal agents walking around the crime scenes in HazMat suits. The CDC estimates that the total economic burden of prescription opioid misuse alone in the U.S. is approximately $78.5 billion a year. This amount includes the costs of healthcare treatment, lost productivity, addiction therapy, and law enforcement intervention. These statistics are startling and only growing worse.
HOW IT HAPPENED
In the late 90’s, many pharmaceutical companies reassured the medical community that patients would not become addicted to prescription narcotic pain relievers. Healthcare providers began prescribing opioids in greater amounts and rates. The pharmaceutical companies started posting record profits with the production of more and more narcotic pills. The widespread prescribing led to abuse and misuse of these medications prior to the medical and law enforcement communities acknowledgement that the problem did truly exist. Moreover, in 2015, more than 33,000 Americans died as a result of an opioid overdose. Not only did this problem lead to the demise of stars such as Whitney Houston, Heath Ledger, and Prince, but it began affecting the health of some of the addicted practitioners as well and even some teenagers worldwide.
Watch this video for a quick review of the opioid crisis facts:
As most people know, misuse and abuse of any drug is potentially life-threatening. Poly-drug interactions (use and effects of multiple drugs ingested in the body simultaneously) can often lead to many unwanted side effects even if the prescription drugs are used as directed. Furthermore, misuse/ abuse of the drugs can only eventually lead to future health-related problems such as heart muscle damage, lung damage, liver damage, and kidney damage. The effects from chronic narcotics abuse can be devastating on the human body and the family structure. Irreversible brain tissue damage is not uncommon as well. Infants born to drug-addicted mothers can suffer from neonatal abstinence syndrome (withdrawal) as well as being born with low birth weights. Furthermore, many IV drug abusers contribute to the spread of HIV and Hepatitis C.
HEALTH CARE PROVIDERS
Sadly, health care providers prescribing narcotics have contributed significantly to the opioid crisis. Some practitioners will write narcotic prescriptions for money, sex, social pressuring, and even out of complete ignorance. We are all familiar with the stories of the stars such Michael Jackson and Anna Nicole Smith who “Doctor Shopped.” When both of these stars were found dead multiple prescriptions for pain killers and sedatives were found in the proximity. Many of the prescriptions were written by different doctors for various reasons. Dr. Conrad Murray testified that Michael Jackson use to beg for the “milk” — propofol (a general anesthetic agent) and that he would administer more to please the star. Dr. Murray could not say, “No!” Many doctors feel pressured to write prescriptions for pain killers due to patient complaints as well. This has to stop.
HOW TO STOP IT
New federal laws have been established that limit the amounts of narcotics produced each year by pharmaceutical companies. Former President Obama authorized $1 billion in funding to expand opioid treatment and prevention programs federally and in the local states. Practitioners (physicians, dentists, nurse practitioners) all have to begin implementing new non-narcotic pain regimens as the initial and standard method for treating pain. If patients fail non-narcotic pain relief regimens, then narcotics at the lowest doses and for the least amount of time should be prescribed. Patients should also be monitored through the federal narcotics websites available to pharmacists and other Rx prescribing health practitioners. Furthermore, staff members and family members of prescribing practitioners that engage in any form of opioid abuse should become “whistle blowers.” It is now a matter of life and death.