During the course of this opiate and drug epidemic, I’ve heard several opinions on whose to blame. Here are the arguments and my take on them.
In all honesty, this epidemic is the result of a perfect storm of many factors that came together and allowed it to explode into the tragedy it is today. It will take decades to unwind from it. My son Charles was a casualty of this epidemic–a young man that suffered from depression and addiction and ultimately died by suicide.
Argument: The doctors started using that chart for patients to rate pain and giving pain medication like candy without thought to what it might do to people.
My take: It wasn’t really doctors that started looking at pain as a fifth vital sign. Apparently the American Pain Society coined the phrase.
Hospitals insisted that their staff be more aggressive in treating pain as a result of new guidelines which included the “pain scales.” Apparently, poorly managing pain put clinicians and hospitals at risk for legal action for one.
There were a lot of other insurance changes that resulted in doctors having to spend less time with patients, thus creating an environment for prescribing more pain pills in some instances.
From the surgeon general’s letter to physicians. “Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.”
- I feel that the issue started with those “pain scales” and the fact that someone in this process started looking at pain as a condition instead of a symptom
- There is a small percentage of doctors irresponsibly prescribing
- The education doctors get about pain medication usually comes from the pharmaceutical companies. To me, that’s like the drug dealers educating your teenager on the substances they are pushing. We could do better educating our physicians on medication
The pharmaceutical companies
Argument: They marketed opioids aggressively stating that they were not addictive. In 1991, Americans were issued 76 million prescriptions for opioids. By 2013, that number had nearly tripled to 207 million.
My take: This is true and pharmaceutical companies, particularly Purdue Pharmaceuticals, most definitely bears a lot of the blame. Their intent was to make money and their campaigns were aggressive. I don’t think their intention was to create the most out-of-control drug epidemic in history.
But now they are profiting from the epidemic still with long-term use of Methadone and Suboxone. (The makers of Suboxone is Indivor, headquartered in Richmond, Virginia.)
Purdue Pharmaceutical’s exclusion of facts regarding their prescriptions has been documented. For this reason, I don’t think pharmaceutical reps should be allowed to make a commission off pharma sales just like police shouldn’t have quotas for arrests. It poses ethical issues and health risks and in the case of this epidemic, too many deaths.
Somehow, OxyContin, designed for cancer pain relief, became the drug prescribed for back aches and tooth aches. I have heard all kinds of arguments on both sides of this one as to who is to blame, but at some point it became commonplace. Add to that, flow of oxycontin was making it into the hands of criminals and the pharmaceutical company was not reporting it.
This section alone could warrant a book. And if you want more information, this is a very good article.
Argument: It’s the drug dealers that are at fault. We need to be more aggressive about putting them in jail.
My take: If it’s one thing we do well, it’s building jails and putting people in them. We are experts at warehousing and not tackling the core of a problem.
If a drug dealer dies or gets put in jail, there are 100 more to take their place. We created the epidemic, and drug cartels saw opportunity. Those cartels targeted suburbs, where the OxyContin prescriptions were being filled and dispensed.
And that’s where the money was. As long as there is big profits to make, there will be drug dealers. Decriminalizing drugs like Portugal has done, goes a long way to demote drug dealers.
Who wants to work at Taco Bell when you can make in a half a day what you make in a month at a fast food restaurant? Many local drug dealers are our kids because they get sucked in and the earning power is so intoxicating. They start with minor trafficking and they are pressured to sell more and harder substances until they find themselves in the center of something they no longer want to be in with no way out.
Add to that, many of those “drug dealers” are also addicts who sell to feed their addictions, something their brains are telling them they must have to survive. I’m not saying that drug dealers are not at fault. But I feel they are a symptom of a much larger issue.
Argument: My son got hooked because of that kid at school that introduced him to drugs.
My take: More than likely, your kid was introduced to drugs in your bathroom cabinet or after having wisdom teeth removed. It could have started with Reddi-Whip can (nitrous oxide inhalant abuse) or even your vanilla extract (40% alcohol).
He gravitated toward the “bad crowd” only after it became a habit or an addiction. Truth is, they found each other and most likely the majority of them suffer ADHD and/or a mental illness that inspired them to reach out for something to make them feel better.
I have heard many a parent blame their child’s drug problem on a “bad crowd.” Studies show that the catalyst to drug addiction is pain meds prescribed after surgery followed by your leaving medications accessible in your home. Lock up benzodiazepines, stimulants, dog’s medicine and narcotics because our lack of due diligence is helping fuel the epidemic. If any teens are in your home, there is a chance that one of them is “skimming” your meds to get high.
Compensation has been tied to how patients rate their doctor for pain management which encourages overprescribing of pain medication. This is currently being changed.
In circumstances where we might do weeks of physical therapy or pain pills, many Americans are quick to take the easy way out. We are so busy and we will typically ask for the easy fix, a pill instead of doing what we need to do. That leaves our cabinets full of unused medication.
We have also been sloppy as it relates to securing these medicines. Your kids are either using them and becoming addicted or making money off them. Even Ambien is abused. Find out what you can do to curb the epidemic.
We are also guilty of not talking about mental illness, sweeping it under the rug and ignoring a growing problem. That we can change right now. We can educate ourselves and share articles openly. Eliminating stigma means talking about the problem and recognizing that addiction is a disease.
I’m not perfect and I would love to hear what you have to add to this argument.
2 thoughts on “Who is to blame for the opiate crisis?”
As a nurse also, I have read some literature indicating medical facilities encourage doctors to hand out pain prescriptions; this supposedly improves the patient’s perception of the care they are receiving thereby improving the ratings on satisfaction surveys!
Right on–Anne! So much of this article describes commonplace occurrences as pain management evolved in the early ’90’s. As a nurse, I remember this transition very clearly. . Thanks for posting. Thanks