The Opioid’s Crisis

For the common man and woman, the prevailing query and curiosity around the opioids’ epidemic is how pain-killers’ addiction could be causing so many headaches…Persons are finding great difficulty in grasping how pains and pain-killers are killing so many.

I rather like the way that Jim Miller puts it “The main reason opioid addiction has become such a problem for people, is because over the past two decades, opioids have become a commonly prescribed (and often overprescribed) medication by Doctors for all different types of pain like arthritis, cancer, neurological diseases and other illnesses that have become common.”

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–Mr. Miller pointed out that nearly one-third of all Medicare patients–almost 12 million people were prescribed opioid painkillers by their Physicians during 2015, that same year, 2.7 million Americans over age 50, abused painkillers.

Readers, I feel compelled to write on the addictive nature of opioids, because traditional personnel(reportedly) still cannot grasp or understand how so many persons especially the rich and the privileged, as well as super-Stars like Prince and Michael Jackson could have become so dependent on pain-killers.

The dependency on pain-killers and opioids has opened up wells of illegal activities from Medical-Doctors who are issuing the prescriptions; manufacturers who are making the substances available on markets; and salespersons who are reaping healthy incomes.

–Journalists-Laura Dimon, and Ginger Adams Otis are reporting that Opioid distributors alone make nearly $500 billion a year in revenue.

The situation has become so critical and serious, that the American President has appointed a Task Force to look into the crisis; while States have been forced to establish treatment centers in order to address affected persons.

Readers, in this commentary, I am going to present some of the latest Hypotheses that have been tabled by Partnerships on this topic, as well as some of the latest alternative solvents that they are advancing.

A SAMPLE

In 2013, leaders at Partnership HealthPlan, the main public insurance provider for Medi-Cal patients in rural Northern California, discovered an alarming trend.

They found that many counties where the Partnership operated had among the highest rates of opioid prescribing and overdoses in the state, Hydro­codone was the top-prescribed medication among Partnership patients, who include more than 570,000 Medi-Cal recipients from the vineyards of Sonoma County to the redwoods on the Oregon border.

In Lake County, a poor, rural area bordering Sonoma, enough opioid painkillers were prescribed in 2013 to medicate every man, woman, and child with opioids for five months, according to the California Health Care Foundation.

“If people were needing more, you just prescribed more,” said Dr. Marshall Kubota, he added “that was a recipe for disaster.”

Opioids, a highly addictive class of compounds that includes OxyContin, Percocet, and Vicodin, are a uniquely American form of pain treatment: In 2014, the United States consumed nearly 70 percent of the world’s supply. As prescriptions have soared since 1996, when Purdue Pharma introduced OxyContin, opioid addiction and overdose rates have outpaced the trend. Yet chronic pain levels have increased, according to a recent study in the medical journal Pain—and many people who started on painkillers have transitioned to other illicit, stronger opioids like heroin or fentanyl. As a result, drug overdoses, most involving opioids, kill more than 1,000 Americans each week on average—more than HIV did at its peak in the mid-90s.

 

ALTERNATIVE TREATMENTS

Personnel looking for solvents to the Opioids’ crisis are seeking to answer this question–How does a system of doctors change the decades-old practice of treating pain—from an ankle sprain to a chronic back problem—with addictive pills? And if not opioids, what do you give patients in pain?

Last year, the Centers for Disease Control and Preven­tion recommended that doctors avoid prescribing opioids for chronic pain and instead pursue alternative medications. Some anti­depressants and anti-seizure drugs can help quiet down the brain’s pain signaling. Physicians have found that sleeping pills can also be helpful, since chronic pain interferes with sleep, leading to a snowball effect where the body doesn’t restore itself as well as it would otherwise.

Evidence also suggests that the chemical compounds in marijuana could help some types of chronic pain, too. (And such studies aren’t just from California hippies: A recent New England Journal of Medicine article, co-authored by National Institutes of Health Director Francis Collins, says there is “strong evidence” that cannabinoids can treat pain.

Even for acute pain, like that from a broken bone, opioids are often prescribed when a carefully calibrated cocktail of over-the-counter medications can do the trick just as well, says Nora Volkow–Director of the National Institute on Drug Abuse.

For example, one study published by the Journal of the American Dental Association found that a combination of ibuprofen and Tylenol is more effective in treating pain after wisdom teeth extraction than oxycodone. Another study in the Canadian Medical Association Journal found that for kids with fractures, ibuprofen is just as good at curbing pain as morphine.

Some Medical Firms are requiring their physicians to attend courses about pain management, in order to examine moving from “Rational and Irrational Opioid Prescribing” to “The Art (and Very Little) Science of Tapering Opioids.” They are developing guidelines for emergency rooms and dentists—including the use of Tylenol and local anesthetics before resorting to opioids to treat dental pain.

They are also hoping to prohibit doctors from prescribing more than 30 days of opioids unless a patient went through a strict authorization process.

Other significant alternatives being worked on, involve taking some opioids off medication-plans altogether; suggesting antidepressants and anti-seizure medications for pain management; and offering alternative treatments to patients, such as chiropractic sessions and acupuncture.

It is being reported that the prescription of opioid-alternatives, was

a tough sell for doctors, the hardest part being   when Doctors had to inform patients that the new policy likely wouldn’t cover their continually increasing opioid dosages.

According to the California Health Care Foundation, Physicians now require a signoff from another Doctor specializing in pain management, oncology, or palliative care to prescribe high doses of opioids or brand-name pills. In addition, Opioids prescribed by emergency department Doctors are limited to three days.

Commenting on the prescription of alternative medications, Physician-Marie Mulligan says that after she curbed opioid prescriptions, her patients took on old hobbies that they had abandoned because of the pain; some have gone back to school or become more involved with their families. As she puts it, “It’s getting them to gradually wake up.”

GOVERNMENTAL ACTION

Apart from the alternatives that I have outlined above, it has been announced that a Bipartisan Coalition of Attorneys-General from 41 U.S. States was going to launch a weapon in America’s fight against the opioid crisis.

The Coalition is going to launch a multiple investigation into drug makers and marketers; as well as various manufacturers and distributors of prescription opioids.

Through this Bipartisan Coalition, chief Legal Officers across the 41 States will pool resources in order to determine whether some of the companies are engaged in any unlawful practices in the marketing and distribution of prescription drugs.

New York’s Attorney-General Eric Schneiderman indicated that the move to establish a multi-State Coalition was a major expansion of existing investigations into the Nationwide opioid epidemic.

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