April 14, 2023
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The opioid crisis has been a significant public health concern in recent years, with the number of opioid-related deaths in the United States reaching record levels. Over 1,500 people die each week from opioid-related overdoses, a number that has spiked amid the COVID-19 pandemic. Meanwhile, millions of Americans are addicted to opioids (1)
The problem began with overprescribing legal painkillers but grew worse in recent years with the importation of cheap heroin and synthetic opioids, particularly fentanyl, from foreign cartels. As a result of the opioid crisis, national security has been threatened, and the economy has been dragged down. Opioid misuse costs America tens of billions of dollars yearly, not just in health care expenses but also in lost productivity (1).
The government has responded with a crackdown on opioid prescriptions to curb abuse and addiction. However, this crackdown has had several unintended consequences, particularly for patients suffering from chronic pain and the doctors who treat them.
One of the biggest challenges for doctors treating chronic pain patients is the increased difficulty in prescribing opioids. The doctors are under immense pressure to limit the powerful painkillers. They fear the consequences, such as losing their licenses or even facing prison, for prescribing them inappropriately. According to a June press release, the DOJ has aggressively prosecuted doctors for improper prescriptions or fraud since January 2017 and charged nearly 200 doctors and another 220 medical personnel (2).
An NIH study published last fall found that only 5% of U.S. physicians are certified to prescribe buprenorphine, one of the main addiction treatments. The government has tightened regulations and monitoring of doctors who prescribe opioids as part of its efforts to reduce the number of opioid prescriptions. This has made it harder for doctors to provide the medications their patients need to manage their pain. Due to fear of reprimand or disciplinary action, some doctors have even been reluctant to prescribe opioids at all. (2)
Finding alternative treatments for chronic pain patients can also challenge doctors. While several non-opioid options are available, such as physical therapy, acupuncture, and massage, these treatments may not be as effective for some patients. Additionally, these treatments may not be covered by insurance, which can make them cost-prohibitive for patients. That leaves many patients with chronic pain without access to the treatment they need.
Furthermore, it is said that most Americans don’t take their medications as prescribed. In fact, the number is a staggering 50%. This leads to approximately 125,000 premature deaths. (2) Some of this could be prevented with better medication management.
The crackdown on opioids has also led to an increased administrative burden on doctors’ offices. To comply with the new regulations, doctors and their staff must spend more time on paperwork and documentation. That can take away from time spent seeing patients and providing care.
The impact on patients with chronic pain has been significant. Many patients struggle to access the treatments they need. This leaves them in pain and unable to live everyday life. In some cases, patients have been forced to seek out illegal opioids. This is putting them at risk of overdose and death. Unable to access adequate pain treatment can also lead to depression and other mental health problems.
The opioid crisis is a complex issue that requires a delicate approach. While it is essential to address the problem of opioid abuse and addiction, it is also crucial to consider the needs of patients with chronic pain and the doctors who treat them.
One potential solution to the problem is increased funding for research into alternative pain treatments. It could lead to the development of new and more effective non-opioid options for patients. Additionally, more support for doctors in navigating the complex regulations around opioid prescriptions could help alleviate some of the pressure on doctors’ offices.
President Barack Obama’s Center for Disease Control issued controversial, first-of-its-kind guidelines in March 2016. It was advising primary care doctors to prescribe opioids only as a last resort for pain and at the lowest effective dose. The effort to overhaul opioid prescribing began with little fanfare.
Initial prescriptions for acute pain should be limited to three days. Furthermore, for those with chronic pain, increasing the dose should be avoided. Rather than targeting specialists or those dealing with complex, chronic conditions, it was aimed at primary care doctors in outpatient settings.
Many say the lack of suitable alternatives is a significant issue. A bill being drafted in Congress calls for developing non-addictive pain treatments. But that won’t help the millions of people suffering from chronic pain today. (2)
The new rules and regulations have doctors trying to find pain alternatives for their patients. One option that some patients have found help with is the use of Cannabis products, which are becoming increasingly popular as they are becoming legal in many parts of the country. While opioids were the go-to for so many years, it is vital that doctors find other options to treat a patient’s pain.
Most of the time, patients cannot simply stop taking their prescription opioids alone. They will need to seek the help of a medical detox program. This is an intense situation that many don’t want to think about. As most patients are not what they consider drug addicts. But, due to needing this addictive medication, they have become addicts. This is how this crisis started. It starts by taking medications that are prescribed by your doctor for pain reasons. But turns into an addiction that patients cannot control. When they can no longer get opioids by prescription from their doctor, some will seek alternate routes, which are street drugs. Others will need to work with their doctor on finding an alternative that will work best for them.
The opioid crackdown has had several unintended consequences for patients suffering from chronic pain and the doctors who treat them. It is crucial that a more acceptable approach is taken in addressing the opioid crisis that takes into account the needs of both patients and doctors. Increased funding for research into alternative pain treatments and more support for doctors in navigating the complex regulations around opioid prescriptions could step in the right direction. Patients with chronic pain and the doctors who treat them mustn’t be forgotten in the fight against the opioid crisis.
Keystone Laboratories, a CAP-accredited North Carolina licensed laboratory and CLIA-licensed lab, is committed to helping you make important decisions that impact the safety and health of your patients with greater confidence. Clients in 48 states can get prescription drug and substance abuse recovery monitoring, specialized testing, workplace drug testing, screening, and program management services from Keystone. Contact Keystone Laboratories today to receive the industry-leading laboratory testing services!
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