The opioid crisis or epidemic has stayed consistently in the news for a while now. Lawmakers and doctors from all over the country have weighed in on causes and possible solutions. Doctors claim lawmakers have tied their hands, and lawmakers claim doctors aren't doing enough to prevent it.
Somewhere along the line, common sense seems to have left the building, and rather than finding real solutions to an ongoing problem, everyone is now engaged in life and death game of passing the buck. While there will always be street level users of any drug just because it's a drug and they want the high, there are many people that are victims of the opioid epidemic because they originally started taking opioids for a legitimate reason.
This is where the disconnect begins.
It all starts with the doctors
Anyone that has had surgery or a traumatic injury knows doctors fall into one of two camps. They are either going to control your pain, or they are afraid that controlling it will cause addiction. There is no happy medium anymore. The problem isn't that doctors are prescribing these drugs. The problem starts when they STOP prescribing them. Unfortunately, many times it seems that the physician stops abruptly, after referring a patient to a Pain Management clinic.
They feel their job is done, and they are taking no responsibility for the monster they have created. It doesn't occur to them that it can sometimes take months before a new patient gets an appointment for evaluation and treatment with a pain management doctor.
That is months where a patient is faced with chronic pain, and possibly even withdrawal if they have already been on the opioid for long enough. They start going to the emergency department, doctor shopping and eventually find the help they are seeking on the street. By this time, they are being treated like a junkie by the very doctors that played a part in this cycle to start with.
Compassion, caring, and common sense
Once a patient has been started on any opioid medication, it becomes time for doctors to use compassion, caring and common sense in their treatment plan. Doctors are very aware of the chances for addiction and withdrawal. It is morally wrong to put someone on this path and then abruptly pawn them off to another doctor without any concern.
Once the referral is made, your job really should not be done.
It's not as difficult as it seems, truly. If you've had a patient on opioid medication for a week and you suspect this will be a long term treatment, make the referral to a pain management doctor, but continue to treat this patient until the pain doctor has taken over their care. If you aren't prepared to do that, then at least continue to treat them until you have stepped them down off of these medications yourself. When you abruptly stop prescribing a medication you know has the potential for addiction, you need to take ownership of the part you play in driving these people to the streets to deal with a need you helped to create.
The hardest part will be maintaining the paper trail to satisfy the government.
Perhaps that is what doctors should be lobbying for. An easier way to treat their patients without having to worry that they will be investigated for overprescribing these medications. Let's face it; we need to start somewhere because clearly, the current plan in place just is not working.
