The Opioid Crisis is Devastating.

Dr. Adam Tabriz

Unfortunately, it isn’t fading anytime soon, so let’s not denounce the folks in Need of Pain Medication.
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As accurate as it can get, the opioid crisis is a dilemma, but despite being utterly conveyed, it’s not equal to opioid addiction!

The number of people dying of an unintentional overtreatment of opioids veils every other drug combined. In 2015 alone, the U.S. saw 52,404 deaths from a drug overdose, almost 63% of which were from prescription pain medications. Estimated; about 13,000 of the drug overdoses were heroin-related. That number grew by nearly 10,000 in 2016.

The single-year report ending in February 2019 suggests; 2.9% of the lesser total number of overdose demises in the U.S. from the prior year, putting the estimate to 69,029 people.

Nearly 7 out of 10 drug overdose decreases are due to opioids, with 50% due to fentanyl or other synthetic opioids. And, over 22% of the latter cases are due to heroin, 1 in 5 due to cocaine. Another 23% of all overdose deaths were due to methamphetamine or other psychostimulants. Since 1999, a total of over 770,000 Americans have died due to drug overdoses.

Giving to a report, 2018 marked the first waning in drug overdose deaths in several decades.

After a sharp upsurge in the overall national opioid prescribing frequency starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a prescribing rate of 81.3 prescriptions per 100 persons.

The declining overdose death rate also did the overall national opioid prescribing rate from 2012 to 2018. In 2018, the prescribing rate fell to the lowest in 13 years. Whether the latter trend is the direct outcome of the low prescribing activity; or if the reduction in prescribing practices is the upshot of physician’s adaptation of defensive medicine while declining to prescribe narcotics altogether is the subject of ongoing debate.

The Opioid Crisis has Triggered Defensive Medicine.

According to another report, 40% of primary care clinics are not accepting new patients who take opioids on an ongoing basis. Still, as of the 2018 survey, prescribing rates seem to continue to remain very high in certain areas across the country.

While the overall opioid prescribing rate was 51.4 prescriptions per 100 people in 2018, some county rates were six times higher than the others. The latter suggests that the opioid prescribing rates still vary widely across different states and provinces.

Regardless, without access to pain management, there seems to be a risk that patients may turn to other resources for opioid medication procurement outside of a prescription from a regular physician. It also may lead to declined health consequences for their additional medical problems like diabetes or high blood pressure.
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Patients who need Prescription Opioids are not necessarily the ones Overdosing.

The most conveyed sweltering about the opioid crisis remains around the number of deaths that come from prescriptions. These aren’t people who are abusing heroin or some other illicit drug. These are people who are using medication that doctors typically prescribe. Nevertheless, prescription medications are also available in the black market and are not exclusively dispensed or prescribed by doctors. For instance, medicines such as fentanyl are also traded illicitly on the market.

One, logically, can’t shove for underprescribing opioids, which is just as immoral as overprescribing. Also, the opioids available on the streets are in no way the fault of the physicians, even if they are the same kind of medications merely developed for prescription use.

The opioid crisis appears to be a symptom that is not primarily caused by opioid addiction. Instead, it is the consequence of poor drug control policies and the decades-long war on drugs that have been trifling futile. Unsubstantiated anti-opioid legislation is plentiful, thus target the independent physicians broadly, using the behavior of a few bad apples should not ravage the entire stock.

Those physicians who carelessly and for whatever motive prescribe opioid analgesics to patients, notwithstanding proper clinical indications, indeed must be held accountable. Nevertheless, linking the others under the same initiatives over implementing strict directives will, in the end, punish the entire medical community, yet most of all, patients who need opioid medications the most.

The physician’s role is pivotal in collaborating and building alliances amongst each other and patients, short of compromising their independence.

Strict enforcement of regulation shorn of a legitimate foundation is on the rise, not only in the healthcare domain but also mainly for the narcotic analgesic medication. This trend has placed many physicians in a defensive mode, as they are more and more inclined to prescribe pain medications purely to circumvent disciplinary consequences.

One can imagine a patient with chronic crippling pain will find him- or herself in an awkward position to find a doctor who is willing to prescribe a medication, which is more than just an additional agent.

Opioids, indeed, may be harmful to those who abuse them but life-saving to patients in excruciating pain. But, Unfortunately, bureaucracy and medicine are as compatible as oil and water, and once the former takes over the physician practice, it drives to ruins the doctor-patient relationship.

Opioid Dilemma necessitates Personalization.

The obstacles around opioid addiction, abuse, or crisis are complex and multilayered; hence it can’t be unraveled by urging politicians to play to anyone’s interest, neither patients nor physicians. The real solution is heavily invested in the doctor-patient relationship and the weight of the trust between the two parties. The latter can only be realistically possible within the framework of personalized medicine.

The prevailing trend of the last two decades is suggestive of politician’s aversion to independent medical practices. And, consequently, the opioid crisis emerges out of the said politically motivated solutions, which have indeed spread to rural areas and urban communities.

Contrary to personalized healthcare, Population-based customs may pave the way for the reprimand of physicians for violating standards and regulations. Measures that are merely black and white with no versatility are the cornerstone of any physician-patient interaction, more so pain management.
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Despite the overwhelming need for individualizing the care for patients with chronic and debilitating pain, which will allow physicians to address their patient’s problems enthusiastically, the heavy-handed micromanagement further hinders proper care.

The opioid crisis is the symptom of a more widespread “Socio-political” disease. It is neither a medical problem nor a failure on behalf of the physician community. Instead, it is a socio-political upshot of the administrative overhaul of the healthcare system. It affects both the rich and poor equally, while the rich are more perilous to their source of money.

Prescription opioids prescribed relatively have a low percentage of addiction- as a study by Substance Abuse and Mental Health Services Administration relating 87.1 million U.S. adults on opioids found that only 1.6 million (2% ) develop an addiction and abusive behaviors. Individuals with addictive behaviors or traits are prone to abuse drugs irrespective of the means they obtain the narcotic. Similarly, physicians with alternate motives may also abuse their prescribing power. However, irresponsible legislation will only harm patients who genuinely need medication.

Drug companies may correspondingly be responsible for diverting their drug-seeking behavior towards the clinics by making the public and medical community trust opioids are an extra safe option for the typical pain. They may also intentionally refrain from printing necessary information like safety mechanisms, addiction risks in their marketing and promotional activities. It even leads many doctors to perplexity if they contribute to the opioid crisis by recommending the medicine to people who need it, as mentioned earlier.

The opioid overdose and addiction are significant predicaments, even bigger than the prevailing coronavirus pandemics. It kills more people and is a problem that is more complex to address, also though it does not spread precisely the same way as the COVID-19. Nevertheless, the opioid pandemic is still silent, transmissible, and indiscriminate to the socioeconomic state of the person.

Despite spending trillions of dollars on the drug war and robust policies, the opioid prevalence is still overwhelming. The system is perpetually failing the patients and physicians alike. Because they are alienating the physician community that is bound by the hypocritic oath to take care of their patients by forcing them to practice defensive medicine when they should be connecting with the patients even more. A personalized medical environment is when the healer will always comfort their patient during the excruciating pain and suffering or the peak of addiction. After all, addiction is a disease, just like diabetes mellitus, spinal stenosis, and hypertension; but the opioid crisis is the symptom of one-size-fits-all bureaucratic corporate medicine.

#Opioid #opioidcrisis #drugaddiction #addiction #healthcare #Medicine

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