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Doctors must help stem painkiller epidemic

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Posted: Sunday, April 6, 2014 12:30 am | Updated: 8:43 am, Mon Apr 7, 2014.

One of the most difficult challenges any primary care physician faces is the treatment of chronic pain. Each patient and situation is unique. I’ve seen terminal cancer patients trying to live out their last days comfortably, people struggling all their lives with debilitating autoimmune diseases, laborers whose bodies have worn out from years of back-breaking work, and those with depression and other mental health problems that make their experience of pain more intense.

Twenty years ago, as a medical student and resident physician, I learned about new and promising techniques to treat chronic pain. The innovations ranged from biofeedback to acupuncture to cognitive behavioral therapy to trigger point injections — therapies as varied as the types of pain they were intended to treat. Emphasis was placed on tailoring the treatment to the individual patient. Narcotic pain medication was reserved only for cancer-related or terminal pain because of the high risk of addiction. Then, in 1996, a wonder drug was touted as the answer for all kinds of pain with almost no risk of addiction according to the manufacturer, Purdue Pharma. The magic bullet was called OxyContin.

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8 comments:

  • Juan Blea posted at 2:20 pm on Mon, Apr 7, 2014.

    jblea Posts: 18

    Well, the thing is that there's a tendency to target the substance as the root cause of an addiciton. However, addiction itself is usually symptomatic of a deeper issue. It's this deeper issue that should always be targeted as the root cause of an addiciton.

    The thing with opiates is that, while most people do use their Rxs appropriately, those patients with a trauma or PTSD background may find the relief that he opiates provide is a huge payoff. I think that anyone who can prescribe opiates should be aware of the profile of an opiate user. Since opiates are a depressant, those with undiagnosed ailments such as anxiety, depression,and/ or trauma can be more susceptible to opiate addiciton, as opiates allow them to "numb out" and not feel their emotional pain.. There are brief screening tools that medical personnel can employ as part of a clinical interview to try to catch the higher risk potential up front.

     
  • Juan Blea posted at 1:45 pm on Mon, Apr 7, 2014.

    jblea Posts: 18

    No problem...THANK YOU for both writing the article and for the work you do at La Familia...you're a strong asset to our community!

     
  • Wendy Johnson posted at 12:27 pm on Mon, Apr 7, 2014.

    Wendyj Posts: 2

    Yes, that has been corrected.

     
  • Wendy Johnson posted at 12:27 pm on Mon, Apr 7, 2014.

    Wendyj Posts: 2

    Thanks for those additions Juan! All great points.

     
  • Steve Salazar posted at 11:44 am on Mon, Apr 7, 2014.

    Steve Salazar Posts: 867

    They should start with prescribing the minimum required for treating acute pain. A 10 day supply when a 3 day is enough is just tempting abuse.

     
  • Juan Blea posted at 11:11 am on Mon, Apr 7, 2014.

    jblea Posts: 18

    I congratulate Dr. Johnson for her recognition that medical doctors should become more active in reversing opiate addiction trend.

    I would like to point out three(3) items not covered: 1) Pharmacological intervention fpr addiction is shown most effective when coupled with counseling; 2) While pharmacological interventions are indicated for both opiate and alcohol addiction, very fewf prescribing physicians employ such methods; and, 3) Suboxone is also abused on the streets (it is a combination of Buprenorphine, which is an opiate, and Nalexone), which reinforces the need for a wide educational campaign about the appropriate use of any and all pharmacological interventions.

    Again, this was an informative call to action and I believe Project Echo can provide suboxone certification for prescribing physicians (at this time DEA regulations only allow MDs to prescribe Suboxone). Project Echo can be reached at: (505) 750-3246

     
  • Mel Hayes posted at 9:16 am on Mon, Apr 7, 2014.

    Hobson Posts: 117

    ?

     
  • Bea Merkin posted at 8:33 am on Mon, Apr 7, 2014.

    BeaMerkin Posts: 3

    The apostrophe in the headline is inexcusable.

     
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