Until the government stops treating emergency physicians as the scapegoat for opiate addiction, we won’t be able to address the real issues facing this challenging patient population.
The comments section of Yahoo News is a great resource to gauge the pulse of the common man. Now that Ms. Clinton has taken up the battle cry against Heroin abuse and deaths in our nation, Americans are speaking out. Physicians are being blamed for introducing pain patients to Hydrocodone and Oxycodone, after which they become addicted. When their supply is cut off by their provider, they turn to the streets. Soon they find the only drug that satisfies, and often that is heroin.
The common man has blamed physicians for the making of this crisis. The FSMB, the Medical Boards, and DEA have reacted by hog tying prescription writing of opiates. This particularly impacts the practice of emergency medicine. The Virginia Supreme Court has allowed patients to sue their physicians for malpractice for addicting them to opiates. I submit that those patients were addicts before they discovered opiates. Opiates are just a medication of convenience, and when their source dries up heroin becomes an alternative.
Our Governing bodies have made us the cause rather than the cure. This should be very alarming. We cannot screen for the propensity for addiction, and even addicts need to have acute and chronic pain managed. I would argue that a loosening of narcotic regulations rather than a tightening of them is required to reduce heroin-related injuries. The Government also needs to look at its own organizations and contractors. Why did the heroin in the US before the invasion of Afghanistan represent only five percent of the total from that country, and after it jumped to eighty percent?
We also need to be concerned about the cost of Naloxone. When pre-prepared autoinjectors of Naloxone are $360 for two, we need to question whether it is priced meaningfully for use by addicts and their kin. We cannot provide a safety net when the net is priced beyond the reach of the target consumer.
As emergency physicians we are the experts in acute pain management. It is time we address the issue to our respective governing bodies, and help them to understand that we did not create the heroin crisis. Neither did we cause the pain that led to opiate abuse. We are here to treat it, to help, and in the end to cure not only the injury and ills of our patients, but the society as a whole.