Perspectives on the Opioid Crisis: How Physicians Can Fight Against Drug Abuse
January 18th, 2019
As a Risk Consultant, I am regularly confronted by the opioid crisis affecting our nation. Each day seems to bring new questions and concerns from our member physicians, who want to fight against deadly opioid addictions but often lack the resources to do so.
As a mother, I also see the devastating effects of opioid abuse on the youth within my small Philadelphia suburb. My two sons, who are 23 and 26 years old, have attended the funerals of 11 schoolmates in the past three years alone. The cause of untimely death for each of these young men has been an overdose of either opiates, heroin, fentanyl, or some combination of the three. All were gifted athletes, and most were initially prescribed opiates for a sports-related injury.
Unfortunately, my experience is not unique. Recent research from the University of Michigan found that one in nine high school athletes has abused a prescription drug. In fact, the study also revealed that athletes are prescribed opioids at twice the rate of other adolescents, so that they can continue to play while injured.
Narcotic addictions can happen rapidly. According to the Mayo Clinic, researchers have found that the risk of long-term use and potential addiction increases after only five days on opioids, often leading to abuse of other substances. In fact, when examining national-level general population heroin data, the National Institute of Drug Abuse reports that nearly 80 percent of heroin users reported prior use of prescription opioids.
For doctors who want to aid in the fight against opioid and narcotic addiction, particularly among young people like those in my community, there are multiple ways to protect patients.
- Stay informed. Physicians should seek out information about the prevalence of opioid misuse to make informed treatment decisions for all patients. Young people are often initially exposed to opioids through prescriptions from physicians and dentists. With these treatments, providers can unknowingly and inadvertently contribute to prescription drug misuse.
- Explore alternative options. Some viable pain management alternatives include physical therapy, acupuncture, and local anesthetics or nerve blocks. If a patient requires the use of painkillers, non-steroidal anti-inflammatories, such as acetaminophen or ibuprofen, can often effectively control moderate pain as well as significantly reduce severe pain.
- Educate patients on the risks of addiction and overdose. Prior to the start of treatment with opioids, physicians should have a frank and open conversation with patients about the potential risk of opioid dependency and the consequences of overdose. Physicians should also teach patients about safe methods of medication storage and disposal.
- Avoid long-term exposure. Physicians should attempt to limit the duration of treatment with opioids when possible. By limiting the prescription to less than five days, the chances of long-term dependency decrease significantly.
- Closely monitor patients. Physicians should stay alert for potential signs of opioid abuse with monitoring techniques, such as urine testing, pill/patch counts, and reviewing their state’s prescription monitoring program (PDMP).
For additional resources on this topic, including pain assessment tools, narcotic medication treatment agreements, and documentation tools, Medical Mutual members can access our Chronic Pain and Controlled Drugs Toolkit. Members are also encouraged to reach out to our Risk Management Department at 800.662.7917 if they would like further guidance on the issue.
Janet McCrossen is a Medical Mutual Risk Consultant based in Philadelphia, PA.