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Doctors overprescribe drugs, feed epidemic

President Donald Trump declared the opioid crisis “a public health emergency” in his speech on Oct. 26, 2017. There, he urged medical professionals and health-oriented communities to focus all efforts toward reducing opioid-related deaths and addiction.

The Centers for Disease Control (CDC) explains that the term “opioid” covers a variety of controlled substances that possess pain-reducing properties. The more common variations of the drugs are the schedule 1 drug Heroin, prescription drug Oxycodone and a synthetic variant, Fentanyl.

The CDC claims that since 1999, more than 650,000 American lost their lives to overdoses pertaining solely to this group of drug. The health organization says that widespread attention to the issue, however, only began when death counts dramatically spiked in 2015 because of the increase in circulation of synthetic painkillers, such as Fentanyl, which the National Institute on Drug Abuse (NIDA) claims to be 50 to 100 times more potent than morphine.

Local family medicine practitioner, Dr. Ann Fitzsimmons, said that efforts reach far beyond political conversations, with organization such as the CDCs successfully changing how and when opioid prescriptions are used.

“I think the current situation has definitely been changed in terms of when you use [opioids] and when you don’t,” Dr. Fitzsimmons said. “There’s lots of different reasons we’ve gotten to this place in the world, but I definitely believe groups like the CDC will make a difference in how people will respond in getting narcotics.”

When looking for solutions, the CDCs and Dr. Fitzsimmons look at the origin. In answering the question “how has the situation gotten so bad?” the family physician attributes the problem to a few primary issues, including a patient mentality of pain being an unacceptable part of the healing equation.

“It’s a multifaceted thing. There’s the patient factor of expectation that they may have. Another one is sort of a lack of appreciation of the dangers of opiates,” Dr. Fitzsimmons said. “I think we are learning more and more that for some people, it really doesn’t take long to get addicted, so using a shorter dosage of prescription is really important. Another factor was [in the past] we were asking [patients] to gauge pain on a pain scale, and there was a real push that we were undertreating pain and a push to do so. I think in [over treating pain], we highlight pain as the most important thing to get rid of, [stemming all these problems].”

In the fashion of eliminating pain, Sophomore Will Ayers’ introduction to opioids occured when he broke his collarbone in a dirt biking accident. Shortly after, Ayers started taking Hydrocodone and later Percocet.

“I took both painkillers consistently. I was prescribed to take one to four pills every two to four hours,” Ayers said. “I didn’t really think that the Hydrocodone worked at all, but the Percocet did work, and I took that for about two weeks after I got the surgery, too. I was able to function completely fine on both drugs, as well.”

In Ayers’ situation, the drug proved to be helpful and non-harmful. This, however, is not the case for many Americans. The NIDA explains that the addiction to such drugs is almost instantaneous, so when a prescription runs out, patients look to the streets to find alternatives. This dark pathway introduces otherwise drug-free and productive patients to look to deadly drugs such as heroin. Still, this situation doesn’t fit the majority of prescription addicts, as DrugFacts.org reports, “While prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse pain relievers switch to heroin.”

One large step in fighting the crisis comes from informing the American people about the dangers of the opioid drugs. For contemporary issues teacher David Graham, the opioid crisis was an ideal example of a modern-day topic that incorporates both science and society. Graham himself has come to the conclusion that the business side of painkiller distribution should be limited, as part of the solution.

“I think it’s a white-collar crime. It’s really hard to prosecute or change that part of it without some help from the drug companies and from the doctors themselves, who aren’t going to be prosecuted even though they’re supplying the majority of those drugs,” Graham said. “I think there are some very ethical drug companies and very ethical doctors, but I think we have to have some help from them because we’re not going to put any executives in jail over these things.”

In relation to Graham’s’ teachings, Dr. Fitzsimmons believes education is key to mitigating the grasp of the crisis yet hopes that medical professionals can perfect the methodology for prescriptions all while trying her best to keep patients off the heavy narcotics.

“I don’t know that we know what [preventative] education methods work best,” Dr. Fitzsimmons said. “… For now, in my career I’m looking to see how I can help my patients. One of the things that have helped me is focusing in on a person’s function rather than eliminating the pain completely.”

What are your thoughts on the epidemic? Comment down below.

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