Spot it: Two Types of Addicts
Opioid overdoses claim a life in the United States every 19 minutes. Some addicts are easy to spot, sold out by their disheveled appearance, open sores, and needles hidden under their stretchers. Other addicts look a lot like the people walking next to you on the sidewalk.
According to CNN Chief Medical Correspondent Dr. Sanjay Gupta, specialists have the second (less visually obvious) type of opiate abuser nailed down to “non-Hispanic Caucasian male, mid 30s”, diagnosed with “back pain due to trauma, surgery, or degenerative arthritis.” The pattern is strong; they even have the time of overdose related death to 31 months out from the first prescription for hydrocodone, OxyContin, Percocet, or other opioid medication.
The American Epidemic
In a 2011 statistic, three fourths of the world’s opioid prescription drugs are used in the US. “Less than 5 % of the worlds population” is using 75% of the worlds prescribed opioids! Yes, some people do experience chronic pain in the US, but sufferer’s deserve a better solution than high-risk and addictive medications.
The “King of Pain”
The origin story of how American Doctor, Russell Portenoy, earned his nickname seems to be a very small drop in the ocean. Unfortunately, the ripples seem to have gained momentum and have grown into a tsunami wreaking havoc on this country.
Dr. Portenoy’s created a limited study in 1986 and went on to produce a paper. The paper conveyed that opioid prescriptions could be easily prescribed to more pain sufferers than just cancer patients. The main message received from his paper, was “ less than 1% of opioid users would become physically dependent or addicted.”
The 1% statistic was derived from a one-paragraph letter Portenoy cited in his study. The single paragraph’s statistic was never given the proper parameters, though, hence the misrepresentation. You see the low 1% addiction rate was only an accurate statistic in a highly controlled hospital environment. The 1% paragraph will forever remind doctors and scientists that a very small miscommunication can deal very large consequences.
Portenoy has since apologized for the part he played in guiding the US towards an addiction riddled future.
Need More Than Narcan
Narcan or naloxone is something like an opiate overdose antidote. There is still a need for more tools to win the war on opiates in America. Narcan is and has been effective, but the belief is that the drugs are getting stronger (fentanyl, the drug that killed Prince) and overdoses are increasing in number. Even with Narcan, opiate related deaths remain stable.
Democrats are working (so far unsuccessfully) to get a bill through congress to put more resources toward the battle. The ER staff is frustrated with their lack of options past the life saving intervention of Narcan and suggesting a rehabilitation clinic. It’s a psychological problem, and that doesn’t have a injectable miracle cure.
There is a necessity to be more cognizant. Dr Sanjay Gupta quotes a recent study which “[shows] that 91% of people who survived an overdose were still able to get another opioid prescription, typically from the same prescribing doctor.” The solution being floated by the Centers for Disease Control and Prevention are relatively simple: don’t prescribe opiates unless absolutely necessary and prescribe the lowest possible dose.
Dr. Sanjay Gupta implores doctors simply set “realistic expectations” for the patient so they are aware that a zero on the pain scale is not the goal. The goal is a manageable level of pain. Being interactive with a patient and discussing treatment openly is the best way to come up with the safest and best treatment option.
More information on America’s battle with opioid addiction: http://www.cnn.com/2016/05/11/health/sanjay-gupta-prescription-addiction-doctors-must-lead/index.html