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How much do physicians contribute to our "Opioid Epidemic"
Keywords:
opioid dependence, prescription narcotics, drug abuse, drug companies, Narcotic epidemic
Started by
Neuro09586
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Category
General Patient Interest
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8

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      Lately, there has been lot of talk about growing epidemic of "opioid dependence". A particularly distressing aspect of this epidemic is because it seemed to have been fueled by prescriptions drugs. Aggressive marketing by drug companies that produce prescription narcotics has been cited as a major reason. In addition, "research" cited by these companies suggested that the likelihood of narcotic dependence is not as high as generally suspected. Some in the medical community who took this "research" at its face-value, of course after being gently and persistently nudged by the drug companies, have promoted generous use of narcotics. The patients who do not want to "suffer" are happier with aggressive pain relief and frown upon "weak" non-narcotic pain-relievers. Most of us, who start our career afraid of "over-prescribing" narcotics, have found ourselves dealing with unhappy and usually very vocal patients asking for stronger pain relief, who then get what they want from another "malleable" or "more reasonable" physician. It is another matter, that some "pain specialists" have made a business out of "meeting" customer's demands for stronger pain relief and have huge and highly profitable clinical practices. These 'pain-docs" prescribe narcotics generously to patients who are now addicted to narcotics.  

      Most physicians do realize the long-term consequences of prescribing narcotics. However, in the current healthcare scenario where customer "satisfaction" is most important, denying a prescription for opioid to a patient asking for one, is a sure recipe for patient dissatisfaction. If this epidemic is to be controlled, it would be important not only to "educate" physicians about use of opioids, but also re-think the whole concept of customer-satisfaction, when patients can radio their dissatisfaction on numerous physician rating websites and hospital patient satisfaction surveys.

 

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Gastro17185

Important problem without any easy answers. I think a strong political will is needed to solve this problem which has a lot of people with vested interests.

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Surg90607

I think the problem is multi-factorial and blame game is not appropriate. The drug companies who promoted the use of narcotics with less than truthful data need to be held accountable, especially since they used financial incentives to physicians for prescribing these medications. The recent federal initiative seems to be step in the right direction.

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Craig87662

I think that physicians carry most of the blame for this epidemic. Patients don't know any better than what they are told by the physicians. There might be some obstinate patients who are drug seeking. However, most patients trust that the physicians would do the right thing and not prescribe something which will be harmful in the long run. In my mind, the physicians are only 'copping out' and taking the easy option by prescribing narcotics so generously.

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AlIMed64297

It is a complicated issue. I am not sure if the physicians can be directly held responsible for making patients addicted to opioids- except the few who prescribe narcotics for financial gains. They should be dealt with very severely. I agree it is quite traumatic to have patients write nasty reviews on the physician rating sites after denying them a narcotic prescription for their own good.

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Cardio21740

Some patients are just keen on getting opioids and will do anything to get it from the physicians. Physicians are being unfairly blamed in this. I never prescribed narcotics to any patient unless it was medically justified.

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OncSurg51524

We need to re-educate physicians about the addiction potential of opioids and about alternatives for pain control. I think there should be protocols which limit the duration for which opioids can be prescribed and someone (like ID does for antibiotic use) who can review if the indication for prescribing opioid is appropriate. This opioid epidemic has grown way more than it should have been allowed to grown. It is not too late to act, be proactive and take definitive measures to control it.

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Pulmon09798

I agree that physicians do play a role in this epidemic. Most people have learnt over the years that there is no point denying patient pain medication because the patients who are drug seeking will keep on irritating the staff and asking for medication till they actually get the pain medication. It is difficult in the present set-up to deny opioids to patients who are hell bent on getting them.

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CTVS10483

I think we should balance the need for pain relief with the addiction potential. They are not mutually exclusive. My patients are in lot of pain after thoracotomy and if the pain was not aggressively controlled, they would be really miserable. But they need to be aggressively weaned of the opioids. I have seen some colleagues who are more generous in prescribing opioids. They are all very nice and conscientious people but just that they don't want the patient to have any pain at all. I suspect some of their patients develop opioid dependence. It is complicated.

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