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Tuesday, June 06, 2017

Arizona Republic editorial asks questions about national Opioid Addiction

Obviously, there isn't a media outlet in the US that's not reporting about the national epidemic relating to the Opioid Crises.  

It's an epidemic killing young people, under 55 years old. 

Although a lot of reporting describes the damage caused by opioid addiction, the money to treat this epidemic is difficult to find.  Yet, the cause seems to be related, at least in part, to medical treatment. Therefore, if health insurance helped pay for the cause of this epidemic, then it stands to reason, there should also be money available to treat the consequences, i.e., addiction.

Like any epidemiology research, searching for the root cause of addiction is like finding the germ that causes an infection or the vermin that injects poison into a body.  

What's interesting about this Arizona Republic opinion perspective, is how the analysis about opioids doesn't include the illegal drug agents, the street vendors who make the toxins available to addicts and thereby exacerbate the epidemic. 

Instead, this Editorial Board's opinion makes the patient and the provider the core cause of the disease.

I object to this point of view- but here's how Arizona Republic sees it, an Editorial Board with no medical provider input, that I know about.

In the newspaper "Arizona Republic" the editorial board raises questions, asking why the drug crises has infected the nation, killing our young people.

Our View: What the opioid epidemic says about us

Editorial: It's easy to blame the usual suspects (and we should). But there also are larger issues driving this crisis (Arizona Republic editorial board)

America is addicted and dying from drug overdoses. 

There’s a lot of talk about who is to blame for the epidemic of tragic young people who are dying from opioid deaths.

There’s a bigger need to ask how our culture enabled this crisis.

Round up the usual suspects.
  • Our pharmaceutical companies got us here.
  • Our doctors got us here.
  • Our desire to escape reality got us here.
Let’s look at them one by one:

Drug companies made big promises

Pharmaceutical companies made a lot of money selling opioid painkillers, and some say they did so without regard to the dangers.

On May 31, Ohio filed suit against five pharmaceutical companies saying drug makers spent “millions of dollars on promotional activities and materials that falsely deny or trivialize the risks of opioids while overstating the benefits of using them for chronic pain.”
A similar suit was filed in Mississippi in 2015, and other states, cities and counties have started litigation.

Some people draw parallels with the lawsuits that states – including Arizona – pursued against the tobacco industry in the 1990s. Settlements totaled more than $200 billion nationwide.

But unlike cigarettes, this situation has a middleman who facilitated the substance use.

Doctors over-prescribed painkillers

Too many doctors failed to look closely at the drugs they were prescribing.

Before the spotlight was turned on this problem, it was not uncommon to hear stories of people returning home after surgery with enough oxycodone to chemically enslave or kill them.

In 2015, more than 25,000 people nationwide overdosed on opioids like fentanyl, oxycodone and hydrocodone, according to the Centers for Disease Control and Prevention.

In Arizona, last year, 790 people died from overdoses of prescription opioids and heroin, according to reporting by The Republic’s Ken Alltucker. That was a 74 percent increase since 2012.

Deaths from heroin – the evil emperor of street drugs – tripled in that time and now account for 39 percent of the opioid deaths.

Painkillers became a gateway to heroin

Experts suggest people who became addicted to prescription opioids are turning to heroin.

Doctors were the gateway for these drugs. Therefore, doctors need to ask themselves if they exercised due diligence before handing out popular prescriptions.

That said, doctors respond to the needs of people with chronic pain — and the tricks of people who doctor-shop for pills to maintain their addiction.

So let's look at the individuals who use the drugs.

It’s hard to blame someone who became addicted to the opioids a doctor prescribed after surgery.

But, continued use becomes opioid abuse, and that is a choice.

We aren’t supposed to say things like that these days. People cling to their victim status. There’s a derogatory label for expecting people to take personal responsibility for what happens to them. Doing so is derided as “shaming.” (In my opinion, do not "shame" the physicians who are treating pain...!!)

The larger issue driving this crisis

But the lack of a strong sense of self-determination and personal responsibility drove this crisis. That's true of the drug company executives, the doctors, the patients and the addicts. (I disagree with this statement. In fact, drug companies, the physicians and the patients were requesting treatment for pain, not as a cure for lack of "self-determination".)

At every level, there was a failure to take a hard look at the consequences of the decisions being made. (Medical recommendations were given to include pain as the 5th vital sign! That was the "hard look" we, meaning nurses and others, were taught to evaluate!)

In Arizona, the highest overdose rates were among those 45 to 54 years old. It’s worth noting that suicide rates in the United States increased from 1999 to 2014, with a sharp rise among men and women ages 45 to 64, according to the CDC.

People in that age group face a much different future than their parents, who often enjoyed retirements supported by pensions and accessible health care. For many who have little savings, less job security and rising health-care costs, the future is a scary place.

Data from Arizona suggests the heroin overdose rate is higher for teens and young adults, who either underestimate the danger of that drug or accept the risk for the sake of escaping a life that is apparently unfulfilling without dangerous intoxicants.
A symptom that society is failing us

This is where we need to ask the big questions about our culture.

What do young people seek in heroin – a drug long known to destroy mind, body and soul?Where was the breakdown in shared moral responsibility that contributed to the prescription opioid crisis?

Where are the social, emotional, faith, family and economic safety nets that people can depend on?

The opioid abuse and overdose epidemic is more than a medical or public-health crisis. It is a symptom of a society that is failing its members.

It is a crisis in which people are apparently so disconnected from a meaningful life that they give themselves to addictive drugs. (IMO, this is much too simplistic a concept.  Drug addiction is related to physiological responses to opioids i.e., "curing pain", as well as to the "meaningfulness" of a person's life!)

We can and should treat the symptoms of this opioid-abuse epidemic. (HELLO? This requires money!)

American also needs to do some soul-searching about the causes of addiction. In my own opinion, like any epidemic- caused by a germ or virus, the root causes must be identified and a cure for the disease must be funded.  Therein is the problem. Drug addiction is a pre-exiting condition and it will be a long time before any health insurance will provide complete coverage to the treatment required to cure this epidemic. Therefore, if the Arizona Republic would like to include integrity into this opinion editorial, the people who wrote the commentary must also call for money to be available to treat the crises.

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