How to End the Opioid Crisis — Page 4

Place blame on the pharmaceutical industry

Did drug manufacturers set the current opioid epidemic in motion? It’s fair to say that they deluged doctors with marketing to convince them that prescription opioids could help patients with common problems like chronic back pain.

In fact, according to the CDC, the pills are generally appropriate only for acute pain — for example, after surgery — and cancer patients at the end of life.

In one study, researchers found a clear relationship between marketing, which might have been as simple as taking doctors out to dinner, and more prescriptions and overdose deaths.

Distributors failed the nation, as well. By law, they must report suspicious orders for narcotics. But they didn’t stop the black market in prescription pills. As just one example, in Kermit, W.Va., with just 392 people, a pharmacy ordered nine million hydrocodone pills over two years.

In total, manufacturers and distributors have agreed to pay more than $50 billion meant to settle waves of lawsuits holding them responsible. The money is meant to help communities deal with the ongoing epidemic.

Give police better technology

In Boulder County, Co., the sheriff’s office is using about $80,000 of the county’s first year of opioid settlement money for technology to help crack down on drug dealers. One tool, TruNarc, is a handheld device that identifies drugs.

Another tool recovers deleted data from a range of electronic devices dealers might use. The county harbors large-scale black marketers. Police seized some 45 pounds of fentanyl, which could have killed thousands of people, in one haul.

Strengthen the prescription drug monitoring program

Many states keep electronic records on painkiller prescriptions to prevent people from “doctor shopping.” The National Governors Association advises states to make the records easier for doctors to use.

Analysts could examine the data to identify patients with possible addictions. The programs could also send reports to licensing boards and law enforcement if they discover suspect doctors or clinics.

Prevent Addiction

Limit prescriptions

A majority of states have passed laws limiting how physicians can prescribe opioids. Prescription lengths can range from three to 31 days. Most states cap a script at a seven-day supply. Others limit dosages.

The rules usually don’t apply to cancer or hospice patients or people getting medication-assisted addiction treatment. But critics say that limits shouldn’t tie a doctor’s hands and could hurt patients. 

Direct access to physical therapy for chronic pain

The CDC recommends physical therapy for common muscle and joint pain — such as stiff necks, arthritic fingers, and bad backs. Research suggests that physical therapy is linked to less risk of taking a painkiller.

One solution would be to encourage insurers to let people go directly to physical therapists rather than through their primary care doctor for a referral. Insurers, public and private, could also remove other obstacles for reimbursement for non-opioid pain management.

Other remedies for pain

• Mindfulness techniques
• Diet
• Yoga
• Radiofrequency ablation

Throw away unused pills

A common-sense solution is to encourage Americans to dispose of old medicines. Over the years, the U.S. Drug Enforcement Administration reports, Americans have thrown away a total of 8,650 tons of pills on its yearly National Take Back Days.

It may be comforting to hang on to your painkillers in case you ever need them again — but know that a visitor or child could get into your medicine cabinet and secretly take your pills. If you must keep them, hide them.

Treat mental illness

In one national survey, 62 percent of Americans with an opioid use disorder also had a mental illness. For about a quarter of them, the illness was serious. Most did not receive medical care for their conditions during the previous year.

The National Institutes of Health is funding several studies that test ways to support primary care doctors, so they can manage complex cases. One approach would to offer patients direct support and primary care doctors regular consultations with psychiatrists. The patients might have anxiety, depression, or post-traumatic stress disorder. Those conditions can make you more sensitive to pain.

A lack of mental healthcare in the United States isn’t new — but it’s growing worse. In some places, getting an appointment with a psychiatrist is difficult or it’s hard to pay for one or obtain insurance coverage.

Americans in rural areas, where the opioid epidemic hit the hardest, may have more access through video appointments, but they historically have had the least mental healthcare.

It’s not a big leap to say that the opioid epidemic is the price the nation has paid — in people’s lives — for neglect of basic needs.      

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