Author of The Painful Truth
“Next year, how about fewer ads that fuel opioid addiction and more on access to treatment,” White House Chief of Staff Denis McDonough complained on Twitter.
“Was that really an ad for junkies who can’t [poop]? America, I luv ya but I just can’t keep up,” TV host Bill Maher tweeted.
These are only two insensitive comments that were made by high-profile individuals in response to AstraZenca’s 2016 Super Bowl ad, “Envy.”
Payers, legislators, and healthcare systems are implementing limits on how many pills may be dispensed to people with pain in an effort to curb the opioid crisis.
CVS announced this past September they would limit the number of pills new patients with acute pain can obtain to a seven-day supply.
Last July, Maine passed legislation limiting new prescriptions for opioids to 100 morphine milligram equivalents per day for most patients.
The giant prescription benefits manager, Express Scripts, began a program last September limiting people with new opioid prescriptions to a seven-day supply, not to exceed 200 mg per day.
Please note: This version of the blog originally appeared as an op-ed in the Salt Lake City Tribune on December 10, 2017.
The Salt Lake Tribune published an editorial on Sunday Nov 12, 2017, “Medical professionals need to play a role in opioid crisis.” The first line reads, “First do no harm.” According to the editorial, physicians who prescribe opioids to treat pain patients may be violating the Hippocratic Oath, because “a doctor’s first concern is to not do anything to make things worse.”
Pain seems universal and irrefutable. Surprisingly, though, our perception and treatment of pain have always depended on time and culture.
Currently, pain isn’t considered to be as important as the opioid crisis. The voices of people in pain are often ignored. Sometimes, those who have pain are silenced because they fear the consequences — which may include losing their job, their friends, or their status — of telling their stories. That amounts to as many as 100 million Americans who may be actively hiding their pain, and who may feel isolated from a culture that stigmatizes chronic pain patients.
Everyone can agree on a few things. First, we have an opioid epidemic. Second, we want to mitigate it. Third, the efforts we’ve seen at the national level to ameliorate the crisis are not working.
As USA Today recently reported, the opioid epidemic is getting worse instead of better. Two top-level public officials — Dr. Debra Houry, Director of the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control and Dr. Francis Collins, Director of the National Institutes of Health — agree that whatever we’re doing to fix the epidemic doesn’t seem to be working. The amount of opioids prescribed has been declining for 5 years, but the number of overdoses has been increasing. So why are we not making progress?
Meet Rachel * and Lorna. They are very different women, but they have one thing in common: they both used opioids.
One morning, Rachel maneuvered her maroon Civic into a parking place at a local breakfast joint to buy opioids from her dealer. Accompanied by her two-year-old daughter and her brother, she had never felt more like a criminal. While Rachel never turned to heroin or other street drugs, she used prescription opioids for non medical reasons.
Shakespeare may be complicated, but the universal need for sleep is not. The “Chief nourisher” is, indeed, a major function of sleep. It scavenges toxins produced during the wakeful hours which are literally “the death of each day’s life.” It results in “hurt minds” or damage that may be irreparable. Sleep scavenges and disposes of the poisons that allow the system to be revitalized with a “second course” or another day.
Hurricanes Harvey and Irma were tragedies, but if there was a silver lining, it was that they brought out the best in people. They reminded us that humans can overcome partisanship and tribal differences to help one another.
For generations, many of us took pride in thinking of the United States as a melting pot. Our parents and our grandparents came from all parts of the world, and they brought with them a potpourri of languages, cultures, habits, and philosophies. We believed that everyone was welcome and had a contribution to make. After a generation or two, you couldn’t differentiate one group of Americans from any other based on their ancestral origins. That, we believed, was the way it should be.
As of this writing, Hurricane Irma is about to invade Florida. It is reported to be a Category 5 storm. Many people are evacuating, while others cannot leave their homes and must prepare to shelter in place. The region will inevitably experience catastrophic effects, and this is on the heels of the devastating Hurricane Harvey that struck Texas.
When we think of the segments of the population who have been most affected by the opioid epidemic, we tend to think of poor, unemployed people who live in rural areas. In September of 2016, I published a blog called “Tough Times Feed America’s Opioid Epidemic: What You Need To Know.” In it, I described how the disease of addiction and overdoses can infest an economically-challenged community. I referenced a CNN article written by Wayne Drash and Max Blau, “In America’s drug death capital: How heroin is scarring the next generation,” that tells the story of how addiction, poverty, and social issues together have opened the door to increased opioid use and deaths in America’s heartland. Additionally, I mentioned a book titled Dreamland: The True Tale of America’s Opiate Epidemic, in which author Sam Quinones ties the opioid epidemic to the same risk factors: poverty, hopelessness, and unemployment.