Opioids – A Blessing Turned into a Curse?
The opioid epidemic in America has received so much attention that it makes some wonder whether all of the recent media and government involvement is helping or hurting our citizens in the long run.
The White House has declared the opioid crisis a public health emergency. Tens of thousands of Americans die each year from opioid-related deaths.
And yet, pain management is a real issue. We should have the right to pain-controlling medications when needed. And right now, opioids are the most effective option to combat severe or chronic pain.
Pain Management and Care in Relation to the Opioid Epidemic
A new study published in the journal JAMA Surgery found that post-surgical patients are at increased risk of addiction because of the pain medication necessary during recovery. The researchers concluded that patients should be administered smaller doses of pain meds post-surgery and counseled on the risks and proper uses of opioids.
For a year now, Michigan’s University Hospital has been implementing these new guidelines of dispensing fewer post-op pills. The results have been favorable, as evidenced by:
- Patients’ reported pain not increasing
- Requests for refills remaining the same
- Patients actually using fewer pills
Opioids have long been a controlled substance, but new laws in half of the U.S. now limit the number of pills a doctor can prescribe at one time. More hospitals are implementing the practices adopted at Michigan’s University Hospital.
The current regulatory climate is focused on reducing the number of pills dispensed and discouraging patients from using opioids unless as a last resort. Many states expect doctors to present certain talking points to their patients. In many cases, state law requires patients to sign a document affirming they understand the risks and rules of opioids.
Problems in Fighting the Opioid Epidemic
The vast number of overdose deaths related to opioids seems to have frightened America into single-mindedly setting a mission to reduce those sheer numbers. There are many who are caught up in the struggle of opioid addiction. But what about those who are caught up in the struggle against chronic pain?
Are people who suffer with daily pain now S.O.L. and without help?
A nationwide survey finds that 34 percent of doctors feel that moving away from prescribing painkillers for patients with chronic pain issues may be hurting people. More than one-third of the physicians polled reported that pulling back on pain medications prolongs patients’ misery.
Quality of Life Questions
To deny someone suffering in pain the medication we have available through science is a travesty. If we have the medical knowledge available to help people, we should use it.
At the same time, we don’t want to harm others’ quality of life by allowing addictive and potentially lethal medications to go unchecked and rampantly used for nonmedical purposes.
One aspect people forget to consider in this fight against opioids is what people can afford based on what their insurance covers. Insurance companies often do not cover Schedule III drugs. Drugs in this class are far less addictive and often equally effective at managing pain. Many insurance plans do cover drugs like oxycodone and fentanyl, Schedule II drugs, which are more addictive opioids.
Oftentimes, insurance companies require burdensome prior authorizations for drugs like buprenorphine, an effective Schedule III opioid drug. Prior authorizations require time and research from the doctor’s office and are only approved under certain conditions. This is annoying for doctors and pharmacies alike, and can mean a potential waiting period for patients to receive their medication — if it ever gets approved.
Buprenorphine works well for chronic pain while avoiding the typical tolerance and severe respiratory depression that comes with most Schedule II opioids, which do not require a prior authorization.
Why? Money. Pharmaceutical companies and insurance companies are big business. And insurance companies pay for the cheapest effective drugs first. So, because certain opioids are cheaper, doctors and insurers push these medications to patients first.
Insurers restricting more expensive but less addictive painkillers just doesn’t seem right. A doctor’s oath includes the promise to “do no harm.” But insurance companies take no such oaths and make no such promises. They focus on their bottom line. But is this ethical? Is this in the best interest of patients?
Perhaps it keeps premiums lower. But it begs the question, “Should insurance companies be for-profit to begin with?”
Doctors have received a lot of criticism for prescribing opioids, but maybe insurers should shoulder some of that blame. It sure seems like insurers are trying to remove the responsibility from themselves and not factor in the best care and quality of life of the insured.
Now, because of the harrowing opioid problem, insurance companies are starting to limit the opioid medication they will cover.
Many insurance companies cover very little in the way of addiction treatment. That raises another debate that if the insurers are contributing to the problem but unwilling to fix it, where does that leave patients?
What do we do to balance the opioid addiction crisis in the scales of chronic pain sufferers? We want to hear you weigh in on the debate!
Have we lost sight of the real problems of the opioid epidemic? Are people in pain suffering needlessly? Or are we just continuing to shuffle blame and not coming up with real solutions to help those affected by opioid addiction and chronic pain?
Chime in with your opinions and experiences! Be part of the debate, the search for answers and finding a solution. We invite your comments below, or feel free to discuss this topic in our forum.