Doctors fueled opioid crisis. Can they help cure it?
Even as more than 64,000 people in America died in 2016 of drug overdoses — 40 a day from prescription opioids alone — doctors continued promiscuously writing prescriptions for the drivers of this horrifying epidemic.
Far too many physicians haven't changed their prescribing habits, even in the face of government guidance, state restrictions, heavy news coverage and studies showing the advantages of other painkillers.
More than 61 million people — one out of every four adults in America — received at least one prescription for an opioid painkiller in 2016. Are Americans really supposed to believe that roughly one-quarter of adults is in enough pain to require opioids?
In New Hampshire on Monday, President Trump announced his latest plan to deal with the epidemic. His call for emulating countries that execute drug dealers garnered most of the headlines. And the plan, like his declaration last fall that the crisis was a public health emergency, lacked sufficient detail and funding.
But at least on the prevention side of the problem, the president was on to something when he said that “the best way to beat the drug crisis is to keep people from getting hooked on drugs to begin with.” He set a goal of reducing opioid prescriptions by one-third over the next three years, and ensuring that federally reimbursed prescriptions follow best practices.
Physicians, many of them wellmeaning, helped fuel the crisis by handing out opioids like candy. Now they can be of enormous help in bringing it under control by preventing the creation of new addicts.
The challenge is to act with a scalpel and not a sledgehammer, so as not to drive addicts to even deadlier street drugs, or to deny needed medication to people with chronic pain.
Maddeningly, many of the doctors who are part of the problem have shown little inclination to solve it. Some are even profiting from their association with opioid manufacturers.
Opioid makers paid hundreds of doctors six-figure sums for speaking, consulting and other services in 2014 and 2015, according to an analysis by CNN and Harvard researchers published last week. Large prescribers were the most likely to get paid.
Recent research has also shown that for arthritis pain, other drugs work as well as, or better than, opioids.
To end overprescribing, several states have passed laws limiting initial opioid prescriptions for acute pain to about a week. These restrictions are blunt tools, but when other efforts have cut prescriptions by less than 15% since 2013, they become necessary.
Prescription opioids have become gateways to heroin, to illicit fentanyl and too often to death. A top priority is to keep more people from walking through that door in the first place.