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Opioid Addiction: Doctors, Patients Must Play a Role to End the Epidemic

 

About one person dies every 19 minutes in the United States from an overdose of opioid drugs. It’s a startling statistic and underscores just how the significant the opioid addiction epidemic is in this country. Some other troubling facts from the Centers for Disease Control and Prevention include:

  • Over 2 million Americans are currently battling opioid addiction
  • More than 47,000 Americans died in 2014 overdosing on opioids, from legal prescription drugs such as hydrocodone and oxycodone to illegal substances like heroin.
  • About 78 people die every day from opioid overdoses
  • The United States is the largest consumer of opioid prescription drugs in the world. As of 2011, 75% of the world’s opioid prescription medications are prescribed and consumed in a country that makes up less than 5% of the world’s population.

What’s causing so many people to become addicted to opioids today? Opioid prescription drugs. If abused, these medications can become highly addictive. Overdoses on these medications can result in death. Also, many people once they run out of opioid medications and/or can no longer afford it, they tend resort to cheaper and illegal alternatives like heroin, which are far more addictive and deadly.

CNN addressed many of the top issues surrounding opioid addiction in a special town hall, “Prescription Addiction: Made in the U.S.A.”, on Anderson Cooper 360 Wednesday night. The show was hosted by Anderson Cooper and also featured a panel of physicians and addiction experts, including CNN Chief Medical Correspondent Dr. Sanjay Gupta, Baltimore Health Commissioner Dr. Leana Wen, addiction physician and expert Dr. Drew Pinsky, and Dr. Mark Rosenberg of St. Joseph’s Healthcare System.

The program also featured questions and commentary from former opioid addicts, addicts in recovery, law enforcement, addiction professionals, and concerned citizens. Following are some of the questions that became the major discussion points during the town hall.

What’s Causing the Opioid Addiction Epidemic?

There are many factors that are behind the opioid addiction epidemic, but the experts at the town hall agreed that is a preventable problem.

“This is a public health epidemic, but it is completely man made,” said Dr. Gupta.

Dr. Gupta says physicians play a role in the opioid epidemic because they prescribe the opioid medications in the first place.

“Most of the blame, however, belongs on the shoulders of the American doctors themselves,” Gupta said in a CNN article. “ I am a practicing neurosurgeon, and this is not an easy thing to acknowledge. The fact is, we have accepted the tall tales and Pollyannaish promises of what these medications could do for too long. As a community, we weren’t skeptical enough. We didn’t ask enough questions. We accepted flimsy scientific data as gospel and preached it to our patients in a chamber that echoed loudly for decades.”

The town hall also discussed how physicians need to be more careful on which patients need opioids and which do not. Joseph Putignano, a recovery opioid addict and acrobat, says he was prescribed opioid medications even though it said on his chart that he should not have them. He said being exposed to opioids gave him an obsession for several months after.

Special Narcotics Prosecutor of New York City Bridget Brennan joined the discussion on the role of physicians in opioid addiction by talking about her experiences on the job. Her office successfully prosecuted one doctor for manslaughter after 16 of his patients died from overdoses. She admitted that was just one of the many cases they worked on.

“We started looking at this when we found doctors who were acting like drug dealers. They were literally exchanging prescriptions for cash and the addictive pills were flooding the street corner markets,” Brennan said. “We found that there was really little effective regulatory agencies that were looking at it. They didn’t seem to have much impact and it was a public safety crisis.

“We found that dozens of patients were dying and when we did our investigations, we would find letters from the health department in the files warning the doctor, but the warnings had no effect. So when we saw that nothing else was having an impact, as prosecutors we were sort of the last line of defense and we stepped in.”

Dr. Gupta added to the discussion about over prescription by doctors by saying, “91% of people who overdose, and survive, are given another prescription for those opioids.”

Along with doctors, patients themselves also have a responsibility to prevent an opioid addiction from happening in the first place. Patients should only take the medication as it is prescribed and follow the guidelines of their doctor. No patient should try to take more than what is prescribed in an effort to treat pain.

How Can We Get the Doctors and Hospitals to Stop Over Prescribing These Addictive Drugs? Also, What Should Patients Do to Prevent Opioid Addiction?

The CDC recently set up several guidelines that all doctors are now required to follow to prevent over prescribing of opioid medications.

“We have to get all doctors to follow these guidelines, but we also have to get patients involved too,” said Dr. Wen. “I urge for all patients to ask your doctor every single time, ‘Do I need this medication? What are the side effects? What are the alternatives?’ … We have this culture of giving a pill for every problem, this culture of a quick fix, and that’s something we have to change.”

Should Opioid Prescriptions Be Different for Children and Adults?

Tracey Budd, who lost her son due to opioid abuse, asked the panel: “Should opioid prescriptions be different for kids and adults?”

“It’s a tricky question,” said Dr. Wen. “This is why medicine is both an art and a science. There’s no one-size-fits-all solution. We have to tailor the treatment to each person depending on their age and what it is that they have.”

Who is at Risk for Developing an Opioid Addiction?

Maureen Morella, whose son Jesse suffered brain damage as a result of abusing opioids, addressed her concerns at the town hall.

“At sixteen he began experimenting with opioids with friends, and we saw nothing,” she said. “So what are we missing is my first question and secondly, it is inevitable that you become an addict if you’re experimenting with opioids?”

Dr. Gupta responded that people who have an opioid addiction are “not always that obvious.”

One of these people who did not appear to have an addiction until they sought for help is former NFL quarterback Ray Lucas. He shared his story of how over time he developed an opioid addiction that resulted in him taking over 1,400 pills a day. During this time, he had a TV gig covering the New York Jets. He said:

“I was a functioning addict. The day before I would go on TV, I would stop taking the pills, do the show, and I could swear as soon as my producer was in my ear saying, ‘Five four … ‘ the pain would rush back. So I would go downstairs, and I would take 15 pills right away. And before I got in my truck to go home, and I only live in Jersey coming from New York, I would take 15 more pills. At my worst, I had taken 80 a day at one point, 40 a day, I mean, this was my life … in reality, this is what I did on a daily basis for a year.”

Lucas said his opioid addiction got bad enough that it bankrupted his family and he says it put his “wife and kids through hell.”

He now says he is not ashamed to tell his story because opioids have “changed the face of what people think are addicts.”

“I’m an NFL veteran, graduated from Rutgers University, but I’m an addict and I will always be that way,” Lucas said. “I survived. I overcame my addiction and I tell my story to make sure people know out there that they can overcome addiction.”

What Do You Say to Patients Who Want to Take Pain Medication Daily?

Kay Sanford said she has had chronic pain for decades and has been treating it with prescription painkillers since the mid 1990s. At the town hall, she said:

“I’ve been on daily opioids that have given me a very full and productive life for the last 25 years. And I’m very careful. I have never misused or abused my medication. I am fully aware that there are many alternative non-opioid things that I can do which I do. I walk a mile and a half with my girlfriends three days a week. I swim. I pay out of pocket for massages two or three times a month. I’m trying to do it right and yet what I know is that there are many patients like me, maybe thousands, tens of thousands, who have tried to do everything right.”

Anderson Cooper then asked the panel: “What do you say to patients like this?”

“Good. Fantastic. This is a situation where no one would ever dream of interfering with her treatment, but that is a very tiny minority,” said Dr. Drew.

Dr. Drew said there are some patients like Sanford who can take opioids daily, but the determining factors depend on genetics, how people respond to medication, what their potential for addiction is, and how they respond to pain.

Dr. Rosenberg shared an experience that demonstrated why opioids don’t always develop addictions in all people and they are powerful and beneficial medications when used correctly.

“I would like to tell a quick story though about a patient of mine who was a 56-year-old woman who had cancer that had spread throughout her body and I got a call from her daughter who wanted to tell me that her mom was not doing too well and she was having a lot more pain,” Dr. Rosenberg said. “I wanted to make sure she was taking her opioids appropriately. And the answer was no she’s afraid to give them to her. Look what happened to Prince, look what’s happening out there, so as a result, she’s suffering. Opioids have a real role in the management of pain, but sometimes they’re over prescribed and sometimes alternative therapies will do as well and sometimes even better.”

Is Marijuana a Gateway Drug to Opioids and Heroin?

This commonly asked question about addiction was addressed at the town hall. Dr. Gupta acknowledged there has been a lot of research and concerns on the topic.

“The real question is: Does marijuana in some way change your brain or prime your brain in a way that you then need to have, crave something else like heroin or cocaine? And the answer to that really seems to be no,” said Dr. Gupta. “That’s a myth. It’s a myth that’s been propagated for a long time. The idea that you take marijuana and you need to have something else more powerful, scientifically doesn’t hold up.”

Dr. Drew said marijuana is more of a substitution than a gateway.

How Can We Eliminate the Stigma of Addiction So More People Will Seek Help?

One of the reasons why many people with an opioid addiction don’t admit it or seek help is that addiction often carries a stigma. There may be fears on what family members, friends, and co-workers think about the addict once they try and get help. The town hall addressed the concerns surrounding the stigma of addiction and how people can overcome it so they can receive the proper treatment.

Dr. Gupta said physicians need to properly define addiction and educate their patients on it so it is not a blocker to patients and families seeking help.

“[Addiction is] a brain disease. And I think more doctors say that out loud, the more that stigma goes away,” Dr. Gupta said.

Learn more about the stigma of addiction here.

How Should a Family Approach a Loved One with Opioid Addiction?

Alan Forte, a recovering Percocet addict, shared his experience of when his family tried to address his addiction. He said it was “chaotic” in terms of how they tried to address the problem.

Dr. Drew offered some advice on how families should approach a loved one suffering from opioid addiction.

“The one thing I would tell family members is to don’t go it alone. Do not go it alone,” he said.

What Treatment Options Are Available For Opioid Addiction?

At the town hall, Dr. Gupta shared a video of a heroin addict receiving naloxone, often hailed by many addiction experts as an antidote for those in an opioid overdose.

Along with naloxone, there is another medication known as naltrexone, also known as an opioid blocker, that has been proven in many studies to successfully treat addictions to opioid prescription drugs and heroin. Other options for opioid addiction treatment include counseling, outpatient care and treatment centers, and a 12-step program (Narcotics Anonymous).

For more treatment options for opioid addiction, visit our Prescription Drug Addiction page or call our confidential and free helpline at 1-800-259-1361 to speak to addiction advisor.

Sources:

http://www.cnn.com/2016/05/11/health/sanjay-gupta-prescription-addiction-doctors-must-lead/?iid=ob_homepage_deskrecommended_pool
http://www.cnn.com/2016/05/11/health/prescription-addiction-town-hall-recovery-irpt/index.html?sr=twCNN051216prescription-addiction-town-hall-recovery-irpt0307AMVODtopPhoto&linkId=24422250

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