Banding together to stop opioid addiction where it often starts —in hospitals
NASHVILLE—Doctors at some of the largest U.S. hospital chains admit they went overboard with opioids to make people as pain-free as possible, and now they shoulder part of the blame for the nation’s opioid crisis. In an effort to be part of the cure, they’ve begun to issue an uncomfortable warning to patients: You’re going to feel some pain.
Even for people who’ve never struggled with drug abuse, studies are finding that patients are at risk of addiction anytime they go under the knife.
“I had the C-section, had the kiddo,” said Michelle Leavy of Las Vegas. “And then they tell me, ‘It’s OK, you can keep taking the pain medications, it’s fine.’”
Leavy is a mother of three and a paramedic who has dealt with many patients coping with addiction. She welcomed the high-dose intravenous narcotics while in the hospital and, upon her release, gladly followed doctors’ orders to keep ahead of the pain with Percocet pills.
But then she needed stronger doses. Soon, she realized, she was no longer treating pain.
“Before I went to work, I took them, and to get the kids after school, I had to take them,” she said. “Then I was taking them just to go to bed. I didn’t really realize I had a problem until the problem was something more than I could have taken care of myself.”
She said she was becoming like the patients with addiction problems that she transported by ambulance, lying to emergency room doctors to con a few extra doses.
Soon she lost her job and her fiance, before going to rehab through American Addiction Centers and stitching her life back together.
Opioid addiction is a reality that has been completely disconnected from where it often starts—in a hospital. Anesthesiologist David Alfery said he was rarely stingy with the pain medicine.
“If I could awaken them without any pain whatsoever, I was the slickest guy on the block, and it was a matter of enormous pride,” he said.
Alfery is part of a working group at the Nashville-based consulting firm Health Trust behind hospital efforts to set aside rivalry and swap ideas about a top priority: reducing opioid use.
“It starts with patient expectations, and I think, over the years, patients have come to expect more and more in terms of, ‘I don’t want any pain after surgery,’ and it’s an unrealistic expectation,” Alfery said.
That expectation exists in part because pain treatment was institutionalized. Hospitals are graded on how well they keep someone’s pain at bay. And doctors can feel institutional pressure, and on a personal level.
“I just wanted my patient not to be in pain, thinking I was doing the right thing for them and certainly not an