Ask Dr. Scott: The Heroin Question
Looking at Pueblo’s heroin problem from a medical perspective.
Q: Dr. Scott, heroin addiction is a huge problem in Pueblo. What can we do to stop this?
A: America itself and Pueblo in particular has a drug pandemic unlike any other in the world. Today, prescription opioid painkiller medications have caused more addictions, overdoses, deaths, broken homes, and destroyed more lives than any other type of drug this country has ever experienced.
Parkview Medical Center’s Emergency Department reported at least one admission each day with heroin-related symptoms in 2015. A Colorado Public Radio investigation showed that although Southeastern Colorado makes up only 6% of the state population, it garners 18% of its heroin treatment. (Multi-Phase Public Forum: Pueblo’s Heroin Epidemic, March 9, 2016)
The New York Times (April 7, 2016) noted that Pueblo now has the highest per capita murder rate in the state, related to drug trafficking and gang violence, mostly due to “a flood of cheap heroin from Mexico and an eager base of customers from a range of economic backgrounds, some of whom switched to the drug after using prescription painkillers.” In many articles the Pueblo Pulp has dramatically detailed the life stories of what may become a “lost generation” of Americans whose future is less bright and more deadly.
According to shocking new data published in a Center for Disease Control’s Report, (December 18, 2015) there were over 47,000 drug overdose deaths in the US reported in 2014, which equates to 128 deaths each day. Another CDC study found that medical doctors prescribed 259 million prescriptions for opioids, equivalent to one for every American adult. Not only do 78 people die daily from opioids in the U.S., but it also is estimated that 4 out of 5 heroin users started out abusing prescription pain relievers.
We mustn’t forget either that 22 veterans in this country commit suicide daily, equivalent to more than 8,000 annually, many of whom suffer from chronic back pain, depression, neglect, unemployment and opioid addictions — given to them initially by their medical doctors. Compelling evidence suggests the epidemic of back pain is now the No. 1 disabling condition in the nation, military, workplace and world with nearly $267.2 billion in total annual costs in 2008.
One in three white middle-age Americans reported chronic joint pain and one in seven reported sciatica during the years 2011 to 2013. Opioid poisoning may simply be the cost of doing business for the medical-pharmaceutical industry in our state and country. Prescription opioid painkillers for back pain brought in $17.8 billion, and OxyContin alone made $3 billion in 2010. Incredibly, obtaining opioids became more widespread when the FDA recently approved OxyContin for kids.
Physicians are by far the most important sources of opioid pain relievers. However, many overdosed are not originally given prescriptions; they borrow or steal medications from the original recipient of the prescription. Teenage addicts often begin by stealing from the “medicine chest” in the family bathroom. In other words, quite a number of opioid ODs stem from illegal opioid acquisition rather than perfectly legal medical-pharmacy transactions.
Writing of opioid prescriptions is dominated by general practitioners — the family doctors, internists, nurse practitioners and physician assistants that most patients see for common problems — and not by a small cadre of high volume “pill mill” prescribers once thought to be fueling this epidemic. (Chen J, Overprescribing of opioids is not limited to a few bad apples, Stanford Medicine News Center, Dec 14 2015) Just as doctors must refer patients with dental problems to dentists instead of prescribing opioids, so too should general practitioners refer patients with chronic musculoskeletal pain to chiropractors and qualified alternative practitioners as the National Guidelines suggest to “ensure the safest and most effective treatment.” (US Dept. of Health and Human Services, Acute Low Back Problems in Adults, December 1994)
Dr. Mark Schoene, Editor of the international spine research journal BACKPage, also questions the buffoonery to use medical doctors as the portal of entry for chronic pain patients, considering they created this opioid epidemic in the first place. Schoene states “Primary care physicians and pain specialists … are the medical professions primarily responsible for the opioid overtreatment crisis. Are the two professions that helped create the worst pain management crisis in history of modern medicine capable of leading the way forward? That remains to be seen.” (Schoene M, The BACKPage editorial vol. 27, No. 11, November 2012.)
Big Pharma’s quest to cash in on opioids has become a national nightmare for small towns across America where local communities are left to pay the bills for prosecution, incarceration and hospitalization of these addicts. Monetary costs are astronomical but the cost of loss of loved ones, loss of peace and harmony in communities, and loss of hope should not be ignored.
As President Obama said at a recent panel discussion on opioid drug abuse, “This crisis is taking lives. It’s destroying families and shattering communities all across the country. That’s the thing about substance abuse; it doesn’t discriminate. It touches everybody.”
