Addiction is a Disease but Opioid Crisis is a Symptom
The opioid crisis in the US is out of control- 42,249 died from an opiate overdose while the daily count is 116. 11.5 million people misuse prescription drugs which all accumulated to a cost of 504 billion dollars.
The opioid crisis is as real as it gets, but it’s not the same things as opioid addiction! The opioid crisis arises as a symptom that is not really caused but opioid addiction- it is the result of poor drug control policies and the decades-long war on drugs which have been ineffective to the least. It targets the independent physicians which are utterly wrong.
The Story about Opioid Crisis
The pain clinics are said to be one of the major players pushing illegally exported heavily to public houses. One solution the government can adopt is to implement quality training for physicians to teach them the standards and guidelines for dispensing opioids or prescribing them. But such pain clinics are not run by experts!
It is wrong to generalize the subject to such an extent!
Let’s delve a bit Deeper into Nuances of the Real Issues!
Regulations are needed in any practice of the medical field for positive outcomes. But too much of regulatory mandates providing the physician necessary resources for compliance will give rise to counterproductive effects.
Wikipedia defines the opioid crisis as the spike in an increase of non-prescription and prescription drugs in Canada and the US since the 1990s. It was the pharmaceutical companies who convinced the public and the medical community that opioid-based drugs can be safely used to relieve pain without any addictive effects- which was completely against the truth!
As a result, there were 42,249 opioid-related deaths in 2016, and deaths due to overdose increased by 5 times since 1999.
Opiate overdose has always been an integral issue of the USA and is not going to go away anytime soon. But it is also wrong to link the epidemic of this scale with heroin which leads to a matter of controversy.
How can we bring an end to the Opioid Crisis?
If you investigate the cases of the opioid crisis, then you will find some or the other connection with an independent physician practice. The independent practices have been targeted and put under the radar by the DEA, FDA, and other regulatory agencies.
Yet this gives rise to a cause and effect problem! Government initiatives are not targeted at treating the root of the opioid problem- these points to a symptom and not the actual disease. It is fruitless to enforce value-based reimbursement on physicians and make them the target at the same time- how counterproductive can it be?
Physicians will not be able to prescribe opioid painkillers unintentionally to patients in need; which would subject them to audit and checks! Patients have developed a habit of evaluating patients on their expectations and opioids is not something that is going to work in their benefit.
Let’s Focus on the Physicians for a Bit!
The profession of physicians needs to devote their whole life to become what their role in society demands. They are not going to act in the interest of any patient no matter what! But still. Some of them may adopt certain shortcuts in a bid to survive.
Treating pain needs consideration of a vast range of clinical skills such as account clinical, physical, emotional, behavioral, socioeconomic, and mental factors. There is a very thin line physician need to tread on when drawing the line between prescribing opioids and the harm associated with it.
Physicians are there who prescribe opioids based on personalized medicine and professional evaluation needs and they are the ones capable of getting rid of the opioid epidemic. Others who prescribe opioids inadvertently are not the physician but more of a criminal.
But sometimes doctors need to give out opioids based on population-based medicine who are the few bad apples of the lot.
We should not Punish Indiscriminately
Population-based protocols may pave the way for the punishment of physicians and providers for violating standards and regulations. It is especially ineffective in the case of pain management and only leads to chaos. We cannot push for under prescribing of opioids which is just as bad as overprescribing. Also, the opioids available on the streets are in no way related to physicians.
Even opioids prescribed by doctors have a really low rate of addiction- a study by Substance Abuse and Mental Health Services Administration involving 87.1 million U.S. adults on opioids found that only 1.6 million or about 2% to develop an addiction and abusive behaviors.
Drug companies are also causing the problem as they led the public and medical community to believe opioids to be a safe option for pain treatment without any addictive effects. They also prevented from printing necessary information like safety mechanisms, addiction risks in their marketing, and promotional activities.
It even leads many doctors to a dilemma if they are contributing to the opioid crisis by prescribing the medicine to people who need it. So we should look to punish the criminals who indiscriminately prescribe opioids and sell them as street drugs. The pain clinics should also be brought under the purview of the surveillance.
The Opioid Crisis is not Going Away so Easily
Physicians will be a key player to collaborate through building alliances amongst each other and patients without compromising their independence.
It cannot be done by begging as many Congressmen strongly disliked small practices because they are difficult to micromanage and incur up huge costs- both of which are illogical grounds.
We have the required resources and strategy to empower patients and physicians independently- then the politicians will have no choice but to give in favor of the vote bank- no other is going to be as effective!
. The opioid crisis results out of politically motivated solutions which have even spread to rural areas. We cannot make doctors the scapegoats just to prove some mandates! It has become a symptom of “Socio-political” disease. It affects both the rich and poor similarly while the rich are more vulnerable to their source of money.
We need to free physicians from the crossroads of hypocrisy, bureaucracy, ethics, and politics- not focus on the travelers!
