The Opioid Epidemic
Wisconsin has been a leader in proactively attacking the opioid epidemic but the medical community, law enforcement and the courts are struggling to keep up. We need more healthcare providers trained to treat addiction and more funding for both prevention and treatment of opioid addiction. The costs of this epidemic, both monetary and human, are staggering and few of us have been left unaffected. If we fail to address the needs of affected families and children we risk a perpetuation of the crisis.
In my practice I have seen the tragic results of this epidemic. Former patients have died of overdose. Some struggle with addiction and are either in and out of rehab programs or are incarcerated. It is now common to have newborns who spend their first few weeks of life in the hospital weaning off the opioid medications they were exposed to before birth. Especially tragic are the young children left orphaned by the epidemic. I take care of whole families of children who have entered the foster system because their parents are incarcerated, dead or unable to care for them because of opioids.
In October of 2017 the President declared the opioid crisis a national public health emergency. Congress has yet to make meaningful changes to attack this crisis. Americans are dying in record numbers.
I would like to help expedite the implementation of the recommendations put forth in the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
There is no doubt that we need improved border security to stop the flow of drugs across our borders. Most drugs enter the country through check points so improving the technology used to detect these shipments is crucial. But even if all imports were stopped, the overprescribing of opiate pain medications would continue to create new addicts.
About eight years ago I sent an email to many Waukesha county physicians addressing the use of opioid medications for minor pain. One response from an emergency room doctor stays with me. I was told that if they don’t give opioid medications they risk angering the patient and the patient will refuse to pay the bill. Thankfully we have come a long way since then but there are more steps that can be taken to reduce the number of new opioid addicts.
We should make physician education regarding appropriate prescribing patterns mandatory for renewal of DEA licensing. Too many opioid addicts started with prescription medications. Sometimes these were legitimate prescriptions, other times the pills were bought or stolen from someone who had a prescription of their own. We now have the Prescription Drug Monitoring Program (PDMP) in all 50 states which helps physicians identify patients with excessive opioid prescriptions. We can expand these programs to identify patients at highest risk and physicians with excessive prescribing practices by connecting these data banks across state lines. We can further help reduce the number of new pill users by providing drug disposal bags with all opioid prescriptions.
Access to effective treatment of addiction is crucial to controlling this epidemic. Medically Assisted Treatment (MAT) combines therapy with a medication to reduce cravings for opioid and has been shown to be the most effective in treating addiction. Currently there is a shortage of physicians trained to dispense these medications which limits access for many opioid users. Restrictions on inpatient addiction treatment leave many Medicaid patients unable to access these services. Bills to address some of these issues have been introduced but not acted upon.
What are we waiting for?