Dr. D’s Medical Update – Opioid Crisis

The opioid crisis is affecting all areas of our society. In this month’s article, I’m going to discuss how it started, where we stand today and how you can prevent this with your pcp .

As of January, 2019, 130 people were dying daily due to opioid overdoses, these sobering numbers make this an opioid crisis. I’m sure that number is higher now. Opioids are a drug category that includes some prescription pain medications—Vicodin, Norco, hydrocodone, codeine, heroin, and synthetic opioids like fentanyl. Some areas of the country are harder hit than others by this crisis. Some morgues in the Midwest have no room for bodies due to the numbers of dead.

History

The opioid crisis started in the 1990’s when drug companies taught physicians that their drugs were effective and would not cause addiction. As a result, more and more of these drugs were prescribed. For a time, physicians were punished by their medical boards if they wouldn’t prescribe pain medication for their patients. The drugs were then diverted, misused, and abused. By the time it was realized that the drugs were, indeed, addictive, the crisis was on.

In 2017, an estimated 47,000 people died in America from a drug overdose with opioids. At the same time, 1.7 million Americans were suffering from a substance abuse disorder related to opioids. Some things known about the crisis are that around 25% of prescribed medications are misused. Things like taking more medication than prescribed, sharing medication with family or friends, and worse yet, selling pills on the street or bingo halls all count as misuse. We also know that around 10% of those prescribed opioids will develop a use disorder. Finally, 80% of heroin users began by using prescribed opioid medications.

Fighting the Opioid Crisis

With that sobering news, I hope you’re wondering what can be or is being done to combat this crisis. In my practice, I try to prevent addiction and misuse through education, monitoring, and appropriate prescribing. Before prescribing an opioid, we will try other medications or other methods to treat a patient’s pain. Sometimes a regular dose of Tylenol can treat minor aches and pains. For our patients without diabetes or kidney disease, we can use anti-inflammatory medications, like Aleve or Motrin. Our patients sign agreements stating that they will use the medications as prescribed, won’t use any illegal drugs, and will submit to drug testing. This helps us identify those who may be putting themselves at risk by misusing the medications. We also use a program from the state to review prescribing histories to make sure a patient isn’t receiving medications from more than one physician.

Some of you reading this may be on an opioid medication. If so, please have a discussion with your doctor about your use of the medications. There may be other things that can be done to treat your pain. Most importantly, if you think you have a problem with opioid drugs, seek help so you won’t become another casualty in this crisis.

Michael Dominguez, MD, FAAFP is board certified in Family Medicine. His office is located at HealthTexas Medical Group, 590 N. General McMullen, 78228, phone: 210-249-0212.