Could Stronger Ethics Solve the Opioid Crisis?
Image Source: Unsplash
As opioid misuse remains one of the most significant public health problems in modern times, health officials and citizens alike continue to search for solutions. The impact of the opioid epidemic in America cannot be denied: Of the more than 70,000 overdose deaths in 2017, about 68% involved opioid use, according to the Centers for Disease Control and Prevention (CDC).
But overdose deaths are just one of the negative repercussions of opioid addiction. Drug abuse can impact workplace performance, personal relationships, and the economy as a whole. In 2017 alone, total direct costs associated with opioid addiction came to $115 billion. Direct costs include such factors as emergency room visits, long-term addiction treatment, and lost wages.
As opioid addiction is so detrimental to society on a number of levels, it’s clear that we need a viable solution — and fast. It’s time for healthcare professionals at all levels of care to consider the ethical implications of prescribing opioids and look for alternatives in chronic pain management.
Healthcare and Ethics
Image Source: Unsplash
Ethical considerations are a cornerstone of patient care, no matter the diagnosis or treatment options. Doctors and nurses must weigh factors such as insurance coverage, patient age, medical history, and more when determining the best choice of treatment. And when it comes to chronic pain, healthcare providers have other ethical considerations to ruminate over.
Perhaps most notable of these is the threat of opioid addiction. Opioids, which typically produce a euphoric effect and inhibit pain receptors, comprise the majority of the most addictive prescription drugs on the market. Synthetic opioids that are commonly prescribed to treat chronic pain include fentanyl, meperidine, and oxycodone, which is semi-synthetic. Healthcare professionals must weigh the benefits and the potential risks and side effects associated with any medication before making their final prescribing decision. Considering side effects is also an important factor in treating opioid addiction with drugs such as Suboxone and Dolophine.
Ethical dilemmas also exist at the administrative level of the healthcare industry. According to Ohio University, balancing ethics with quality patient care and the needs of a healthcare facility can be challenging. Healthcare administrators also face the possibility of legal action in the event of medical malpractice, and they must put safeguards against potential litigation in place. In some cases, that may equate increased prescriptions of opioids so that patients can manage their pain effectively without the need for follow-up visits or legal action.
Alternative Ways to Manage Chronic Pain
Image Source: Unsplash
Often, the feeling of pain itself is only a small part of the symptoms involved in a chronic pain case. Mitigating symptoms associated with chronic pain — including fatigue, mood changes, and decreased appetite — can be the key to providing effective relief.
Fortunately, opioids aren’t the only option when it comes to chronic pain relief — a combination of methods may be helpful. Many chronic pain patients have been able to effectively manage their symptoms with a combination of prescription medication and other treatment methods, such as physical therapy. Physical therapists typically work in a healthy, controlled environment and use guided exercises and relaxation in order to encourage the body to heal naturally.
There’s also alternative medications to consider. Marijuana, for example, has become much more accepted in medical settings in recent years, and medical marijuana is now legal in 33 states and Washington, D.C. While time will tell if marijuana can help solve the opioid crisis, one of the substance’s active components, CBD, has shown promise in treating chronic pain and reducing inflammation in many patients.
Potential Solutions to the Opioid Epidemic
Image Source: Unsplash
For many years, opioid addiction was seen as more of a problem involving illicit drugs, especially heroin, rather than a product of rampant opioid painkiller prescriptions. During the 1960s and 1970s, the drug methadone was commonly used for heroin detoxification. The country’s first methadone clinics were established in the early 1970s,in response to public concerns over Vietnam veterans returning from war with a heroin addiction.
As opioid addiction became more widespread, other detox drugs were introduced, including Suboxone. Comprised of buprenorphine and naloxone, Suboxone is a Schedule III drug that’s available in four distinct strengths to accommodate various levels of misuse. While the drug does have possible side effects, such as nausea, anxiety, and headache, it has shown promise in treating opioid dependence.
Opioid detoxification can be dangerous and should only be attempted under medical supervision. But treating the underlying addiction may not be enough to effectively curb the opioid crisis. We can’t rely solely on medication when it comes to addiction treatment.
While we still have a long way to go, the CDC reports that the opioid prescribing rate hit a 10-year low in 2017, with 58.7 opioid prescriptions per 100 people. The low rate is encouraging, but that still adds up to 191 opioid prescriptions in a single year. It’s time to give the opioid epidemic the attention it deserves and address it at the source. Reducing the frequency of opioid prescriptions and ethically advocating for alternative forms of chronic pain treatment are required to solve the opioid epidemic.
