By Rob Davidson for Holland Sentinel
For 20 years, I’ve had the privilege of serving as an emergency physician. I’ve cared for tens of thousands of people across West Michigan, from Holland and Muskegon to Zeeland and Fremont. I’ve delivered babies, resuscitated trauma victims, and stabilized heart attack patients and strokes. I’ve treated patients who let otherwise manageable conditions go too long because they didn’t have insurance or couldn’t afford to see a doctor. But hands down, the most common patient I see in the ER is the one struggling with pain.
In the early part of my career, the use of opioid pain killers was rare.
As a medical resident from 1998-2001, I was taught that opioids were only to be used in the acute setting and for the most severe causes of pain, including broken limbs, surgical abdominal pain and cancer pain.
During that time however, Purdue Pharma was in the midst of the biggest marketing blitz of its kind promoting the prescription painkiller Oxycontin. Purdue Pharma’s methods included a bonus system for pharmaceutical representatives who sold the most Oxycontin, and a concerted and well-funded process where physicians and the joint commission convinced doctors that we were under-treating pain. They also used bogus data to show that the potential for abuse of Oxycontin was less than that of other opioid painkillers.
The effect: Oxycontin sales skyrocketed from about 670,000 in 1997 to about 6.2 million by 2002, a nearly 10-fold increase.
By 2003, some physicians grew concerned about the freewheeling prescribing of Oxycontin and other opioids. In 2007, Purdue Pharma was successfully sued for over $600 million dollars for deceptive practices. By then, however, it had already raked in tens of billions of dollars selling the drug. After years of increasing opioid painkiller prescriptions from the late 1990s into the 2000s, those prescriptions began to decline since 2013.
Unfortunately, the genie is out of the bottle, so to speak, and the crisis induced by the unintentional over-prescribing of opioids is still raging.
I routinely see patients suffering from the effects of opioid withdrawal and opioid overdose, including the overdosing mid-20s patient I had to put on a ventilator recently. Despite the decrease in prescribing, the brutal fact is we have created a generation of addicts — patients who got their opioids legally, and people who feed their addiction through illicit means.
As stricter recommendations and laws come online intended to curb the number of prescriptions written, the procurement of more potent opioids like heroin, fentanyl and carfentanil is on the rise as addiction drives the demand for such drugs.
To tackle this public health emergency, many physicians agree that drug addiction treatment is the single most effective and necessary tool against opioid abuse, which led to more than 1,200 opioid-related deaths in Michigan in 2015 alone — a higher death toll than traffic accidents, which killed 960 people that same year.
As a flurry of bills emerges from the U.S. Congress intended to deal with the crisis in an election year, the most important resource to win this war is strikingly absent: We need a foundational shift in the funding of addiction treatment.
This change can only come from a long-term public investment in healthcare. A truly universal health care system such as that afforded by Improved and Expanded Medicare for All is just the prescription for the epidemic that ails too many in our society and in our local communities.
Half-measures and talking points are not sufficient and desecrate the memory of the 115 people who die across the United States every day from opioid overdose.
Opioids are destroying tens of thousands of lives every year across the United States. This public health crisis has also cost more than $1 trillion since 2001, a staggering financial toll that must move Congress to action. Our leaders have been unwilling to act on our behalf, it is time to elect new leaders who will address the current epidemic that is ravaging our communities.”
