The CDC recently came out swinging against primary care docs with guidelines telling them to minimize prescription of opioids in light of the increasing OD epidemic. As much as I agree with the idea, this isn’t gonna solve jack. It’s simply fallacy to say this problem is coming from the PCP doctors without actually dealing with the root of the problem. I’m seriously getting tired of this ‘scape gloating’.
At this point in my career, which isn’t far in by the way, I feel like I have heard it all. From the typical, “I hurt my back and started taking opioids and have been hooked since.” Once in a while you hear “I went in for surgery and was prescribed some opioids for pain management and now I’m hooked.” The media has also adopted the same narrative that puts blame on physicians for prescription drug abuse. But is it true, that physicians are to blame for this ongoing epidemic?
The numbers surrounding this problem are not pretty. 5% of the US population consumes 75% of the worlds prescription drugs. The drugs of interest in this case are opioids, tranquilizers. 52 million people over the age of 12 have used drugs for non prescription uses. According to the CDC, 44 people die daily from prescription OD. Most are in age groups between 25 and 54, while deaths in older age groups are rising. So naturally, the question anyone would want to ask is,
where are the drugs coming from? In a recent study done to determine the source of prescription drugs among users, you will be surprised to know that all the drugs did not come directly from a physicians prescription, infact only 45.8% came from a physician prescription. 18.1% from one physician, 16.6% from a friend, 3.9% from a dealer, and approximately 1.9% from more than one doctor. It was also noted that among teens who abuse drugs, 62% of teen use was due to the ease of access to their parents medication, while another 52% used because the drugs are “available everywhere.”
Now, I’m very sympathetic if the above reason why you got hooked on prescription meds are actually true. Addiction of any kind is difficult to over come and most of us struggle with one thing or another. But here’s my problem, is there any personal responsibility on the part of the addict at all? Because let’s be real, if you’re an adult no one forced your mouth open and shoved a bunch of opioids down your throat until they were addicted. Everybody offered prescription meds CAN REFUSE, and any reasonable physician worth his license will offer you non opioid options first.
I’m not antagonizing anyone’s struggle in this issue, but the media and the public in general are holding this narrative against physicians. A few years back when prescription meds where not being prescribed as much the cry was for “better pain management.” Wherever you went as a health care provider, you constantly heard about how little care patients were receiving in pain management. At the time, “doctors were ignoring patients.” It’s now the exact opposite. The truth is really, physicians cannot tell apart who’s lying and who’s really in pain, and anybody can lie if they want and under this system, no one can challenge them. So if a patients lies to the doctor to get some opioids, and then dies in an accidental overdose, under this current system, thats pretty unpreventable. Unless we find a definitive way to diagnose pain, the burden of pain management and prescription drug abuse should be shared by everybody, including patients.