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Op-ed: To solve opioid crisis, we first must address people’s pain

First Published      Last Updated Mar 09 2017 10:06 pm

A recent poll by UtahPolicy.com found that nearly half of all Utahns know someone, or have a family member, who is addicted to drugs or has overdosed. Opioid addictions are devastating families in communities across the United States, and Utah is no exception. Utah's recently retired medical examiner, Dr. Todd Grey, reports "the most significant issue that he's seen is the epidemic of drug-related overdose death."

It is sad that so many of us have family members who have been caught in the web of addiction. Drug overdose deaths now exceed the number of deaths due to firearms, falls and motor vehicle crashes in Utah.




According to Journey Healing Centers, an astonishing 97 percent of Utahns admitted using diverted prescription drugs without a doctor's permission. "This behavior shows a lack of knowledge if not downright naiveté about how dangerous it is to fool around with potent medications that can addict and kill," says their web site.

Many believe that if we could reduce the use of opioids, then we would reduce deaths due to opioids. This may be true, but the law of unintended consequences says that actions of people, and especially of governments, always have unanticipated effects, such as when legislation and regulations aimed at righting one problem create new challenges.

The problem of opioid addiction is more complex than the lawmakers, Center for Disease Control and Prevention (CDC) and regulators would have us believe. Simply reducing the amount of opioids prescribed will not necessarily affect overdose death rates. In fact, national data has shown a significant drop in opioids prescribed in 2012, 2013 and 2014 while the number of overdose deaths has continued to increase. Most of the increased deaths are due to heroin, or heroin laced with extremely lethal opioids like fentanyl.

Reducing the supply side of the addiction problem does not address the demand for opioids, nor does it help address the needs of people with the disease of addiction. Abuse-deterrent formulations can significantly decrease abuse, but by themselves, their effectiveness has clear limits.

People with pain will suffer without their prescription medication, and that suffering won't save the lives of people with addictions who turn to illegal substances. Additionally, in all likelihood, we will see an increase in suicides from people who just cannot live with their level of pain if they are unable to find adequate treatment for their pain.

We cannot solve the opioid crisis without solving the pain crisis. The crises demand an immediate and a long-term strategy. Immediate steps should include a public awareness campaign. Additional immediate steps should include affordable access to the opioid antidote, naloxone and legislation requiring abuse deterrent opioid formulations be no more expensive to patients than generic (tier 1) opioids. Abuse deterrent formulations have shown a dramatic reduction in overdoses and rates of addiction.

The long-term strategy must include implementing the National Institute of Health's National Pain Strategy (NPS). This is the first strategic plan for transforming and advancing pain prevention, treatment, education and research in the United States.

Educating the public, providing access to effective and affordable mental health treatment, ensuring access to free substance abuse treatment if necessary and decriminalizing the disease of addiction will go a long way toward reducing the number of people with addiction to prescription drugs or who suffer an overdose.

There are solutions, but they will require thoughtful and non-judgmental involvement by all the stakeholders. It is imperative that we allow compassion to lead us forward while science lights the way. Only then will we be able to solve both the pain and opioid crisis in Utah.

Lynn R. Webster, M.D., is a past president of the American Academy of Pain Medicine and author of "The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us." He lives in Salt Lake City.

 

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