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Is the Opioid Crisis Hurting Healthcare? – Phyllis Romero – Medium

The opioid crisis is one of the most controversial and prevalent issues in our society today. The problem is wide-ranging and many are left to wonder how the crisis is impacting healthcare.

An average of 130 people die each day in the U.S. from an opioid overdose. And, just over 40 percent of those overdose on prescription opioids.

Prescription opioids encompass pain medications ranging from oxycodone, morphine, hydrocodone, codeine, and others.

The other 60 percent of opioid overdoses are usually due to illegal street drugs such as heroin or fentanyl.

Many years ago, before the opioid epidemic was in the spotlight, I remember one particular doctor I saw for my chronic health condition who seemed to have a large number of patients in there for pain.

The wait time to see this doctor was generally pretty long so you got to talking with other patients. And some of these patients talked non-stop. I often left that office with a general impression of many of them.

I felt many were addicted to opioids and prescription pain medications. These patients were there for their ‘refills’ or their ‘fixes’ as I often thought.

Many of these people were nervous, talked a lot of jibberish, and seemed to have a lot of unexpelled energy. They’d shake their leg as they sat in chairs, got up often and paced, and had mood changes.

There were also at least a couple of people who walked in without an appointment demanding a refill of their pain meds on the spot. These people would get quite agitated when their demands weren’t met immediately.

Many were told it was too early to refill their prescriptions. Some would make up stories that they’d lost their prescription or accidentally dropped them in the sink.

Clearly, some of these people had a problem.

Image from Pexels

In fact, some were exhibiting classic signs of opioid addiction.

The Mayo Clinic lists the following as signs of an opioid addiction:

  • Seeming high, revved up, sedated, or overly energetic
  • Prone to mood swings and hostility
  • Forging, stealing, or selling prescriptions
  • Taking more medication than prescribed
  • Sleeping problems
  • Requesting a refill too soon or losing prescriptions
  • Going from doctor to doctor to get prescriptions

Abusing opioids can have profound effects on the body. A patient can experience nausea, constipation, and unrealistic euphoria. As their addiction becomes worse, they need more and more of the medication to reduce their pain levels.

In advanced cases, the patient may experience drowsiness, poor coordination, and confusion. At its worse, the patient’s breathing can slow or even stop, leading to death.

Things have changed on the opioid front, and today the good have to suffer for the bad.

There’s a heightened awareness of the opioid addiction issue and as such, many physicians have tightened their standards on prescribing opioid medications. In fact, some of the doctors I see today have signs with large, bold print stating that they will not under any circumstance prescribe those types of drugs.

Unfortunately, this is bad news for people who really need it. I have a dear friend with multiple health issues, including cancer. She’s in horrible pain every day from her illnesses.

She recently underwent a major oral surgery where many of her teeth had to be removed and the surgeon cut deep into the gumlines. Due to her fragile medical condition, the procedure was done at a major hospital and she was put under a general anesthetic.

After the surgery, the pain was excruciating for her. Yet, she was not given any type of pain medication to manage her pain. It was one of the most difficult things she’d ever gone through.

It seems in her case that someone who really needed temporary pain management suffered because of her doctor’s policy on pain medicine.

And sometimes for patients who are prescribed opioids, they’re stigmatized, even though they don’t have an addiction and really need pain control for conditions like bone cancer.

During a meeting of the American Medical Association, the association’s president told the story of a patient with prostate and bone cancer who was shamed by his pharmacist as being a drug seeker. The patient went home and tried to kill himself after the encounter.

And while the CDC has issued guidelines about prescribing opioids for chronic pain, more needs to be done to ensure that patients who really need pain control can get it on a short-term basis.

Image from Haley Lawrence on Unsplash

Some doctors hand opioids out more freely while others won’t consider it no matter what the circumstance.

A male family member of mine went to his physician with a couple of health complaints. One of them was new and recurring headaches. The pain level was only defined as a 4 out of 10.

My relative was merely concerned at the onset and frequency of the pain. But, on the first visit, the doctor prescribed an opioid medication. Even my relative thought it was overkill for the situation.

The gender divide — who is more likely to abuse opioids? Men or women?

According to the NIH, women are more likely to experience and/or report pain to their physicians. They’re also twice as likely to be prescribed an opioid medication. However, men are more likely to die from a prescription opioid overdose.

Joint and back pain are common instigators for patients seeking pain relief from their physicians. In fact, it’s the second most common reason someone visits their doctor.

Image from Toa Heftiba on Unsplash

The NIH reports that eight out of ten adults have lower back pain at some point in their lifetime, and men and women are equally affected.

Back pain will usually get better on its own, but patients often want instant relief. And having previously had back pain myself, I understand why.

But, after having witnessed a number of people become addicted to opioids and further deepening their disability, I decided not to go that route.

Many people are given prescription opioids for chronic issues, like back pain. This increases their chances for dependency and it doesn’t adequately address pain in these situations.

Many patients, like myself, have found that physical therapy, chiropractic care, and even yoga are better options for long-term back pain management.

What’s the answer to preventing more opioid dependency?

A certain amount of responsibility lies with a provider. Patients should be given medication to manage pain for the short-term. But, when a patient continues to return to a physician’s office for refills, it’s time to address the problem.

And physicians who are unwilling to prescribe opioids under any circumstance should reconsider offering them to patients who really need them on a very temporary basis.

Screening of patients for previous addiction issues of any kind should prompt a medical provider to avoid prescribing opioids to these types of patients.

At the same time, responsible patients who need pain management deserve to have a responsible practitioner who will address their needs.

In addition, more emphasis needs to be made on alternative pain management techniques that don’t involve prescription pain pills.

Some of them are:

  • Acupuncture
  • Physical therapy
  • Massage
  • Transcutaneous electrical nerve stimulation (TENS) (often used at chiropractors and units can be purchased for use at home)
  • Movement and exercise

Movement, stretching, chiropractic care, and yoga have all helped me tremendously in dealing with chronic pain.

The government and communities are joining the fight against opioid addiction. Why won’t insurance companies?

The epidemic and its effects have become such a huge problem that many communities are expanding access to naloxone to reverse the effects of an opioid overdose.

Naloxone is becoming more available to prescribers, first responders, and community organizations involved in the fight against opioid addiction.

The U.S. Department of Health and Human Services has also gotten involved and offers an Opioid Overdose Prevention Toolkit on its website.

The kit provides information about opioid risks, how to recognize an overdose, and how to provide care in case of an opioid overdose. It also offers strategies to communities, the health care community, and government at the local levels to help develop policies to prevent opioid overdoses and deaths.

Insurance companies should also consider joining the fight by paying for alternative treatments like acupuncture, massage, and other therapies which have proven to reduce pain.

You’d think that insurance companies could see that it would benefit their bottom line and patients in the long run. Maybe with time, we’ll see an improvement in this area.

If you or someone you love is suffering from an opioid addiction, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a free referral hotline. You can call 1–800–662-HELP (4357) for help.

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