Letter to the Editor

The opioid blame game

Tuesday, January 16, 2018

I read with some disappointment and concern the “Questions linger in state opioid lawsuit” article from Dec. 26. Although the article primarily referenced discussions around the county’s decision to participate in a class action lawsuit against drug manufacturers of opioids, it is the ancillary comments made regarding the opioid epidemic by elected officials that causes me concern.

The existence of an "opioid epidemic" in the country is well documented and its cause is multi-faceted and will require a multi-faceted approach to address it. To simply suggest that drug manufacturers or physicians over-prescribing medications, as was suggested by two elected officials, are to blame for the epidemic is very concerning in regard to addressing the issue in a comprehensive way.

In 2001, the Joint Commission on the Accreditation of Healthcare Organizations identified pain as the "5th vital sign," which sent a clear message that pain should not only be addressed but that the potential existed for eliminating pain altogether. Sometime around 2012, the Federal government created a program that tied some portion of healthcare provider compensation to questions regarding a provider’s ability to manage a patient’s pain. The clear message for the last 10 years was that not only can you aggressively manage pain but that you are being held accountable to do so. Much less was known about the addictive nature of opioids at that time.

I do not offer that explanation as an excuse to let over-prescribing physicians off the hook, nor do I believe this practice is as prevalent as was suggested. It is one factor of many that must be addressed and if our elected officials believe that suing drug companies or blaming physicians is going to fix this issue, it will not.

Although I find no value in placing blame, I’d ask you who is more responsible for the problem. Did pharmaceutical companies understate the addictive nature of their products? Likely. Are there physicians who over-prescribe opioids? Yes. Are there people dealing illicit opioids that have not been apprehended by law enforcement? Yes. Would fewer people with mental health conditions seek substances as a solution if the mental health system were better organized and financed by the county and state? Yes. Has the Federal government contributed to the epidemic by holding providers accountable for addressing pain? Yes. If you are looking to hold someone accountable, the list is long and certainly does not exclude elected officials.

As opposed to wasting time on this exercise, each of the stakeholders should look for solutions for their part of the problem. In the case of local physicians, they are placing patients with long-term opioid therapies on "pain contracts," requiring random drug testing of those patients to ensure they are taking the medications and not selling them, utilizing the state’s "Prescription Monitoring Program" to verify that patients are not obtaining opioids from multiple sources, limiting the quantity of medications, educating patients on the risks of addiction and referring people to treatment who have become addicted to opioids. Solutions require action not finger pointing.

The opioid epidemic has been building for years and its cause is multi-faceted and we should approach the solution in a similar way. This issue absolutely must be addressed as lives are being lost daily to opioid overdoses. My hope is that we spend our time focusing on solutions instead of finding people to blame.

Jason C. Harrington

President and CEO

Lakes Regional Healthcare