The opiate crisis is growing across the nation, and the biggest contributor to this epidemic are poorly trained physicians who don't have enough resources. An expert panel has found that physicians that are lacking in tools or resources are utilizing assessment diagnostics inaccurately to diagnose and treat chronic pain, causing widespread addiction. These experts also call into question the wisdom of having primary care doctors manage those who are suffering from chronic pain, suggesting that specialists address these patients.
The epidemic of those who are addicted to legal opiates has been on the forefront of many experts mind in the last ten years. Currently there are an estimated 2.5 million Americans who are addicted to prescription pain medication, and many within that number are beginning to turn to heroin as new guidelines crack down on the prescribing of these pills. Nearly two thirds of those who are addicted to opiates, began their addiction in their doctor’s office after they were provided with a prescription for their chronic pain. Many of these prescriptions were unnecessary, a trend that has been increasing for years.
According to the National Institute on Drug Abuse the number of prescribed opiates have been growing quickly. In 1991 there were only 76 million opioid prescriptions written for patients, but the number had increased to 207 million prescriptions of medication by 2013. While that number is a decrease from the 219 million opioid prescriptions written in 2011, this data is not promising for turning the tide on the opiate crisis. The more that opioids are prescribed to those who are not educated on the addictive nature, the more that people will become addicted and eventually cross over to heroin use.
Once an individual is addicted, it is difficult to stop using as the withdrawals are painful and terrifying. And the rate of addiction is increasing, as many people being prescribed opiates are unaware of the dangers of their medication. When opiates such as Oxycontin and Hydrocodone are prescribed before a patient has seen a pain management specialist, there is a far greater chance that they are being prescribed by a doctor who has not been specifically educated in pain management and does not understand the important of patient education regarding these medications.
This education is especially important because there is no current way to determine who will become addicted to a prescribed medication. However, there are certain indicators that could be used to predict high chances of addiction, such as low self-esteem and issues with depression and anxiety. This information was found during a 2015 study that included information drawn from 267 prescription painkiller users who have started using heroin. The results indicate that those who are suffering from mental anguish or emotional stress would be more likely to turn to opiates to fix their internal pain as well as their external pain.
With prescriptions being handed out more frequently (patients are sent home with pain medication after any surgery at this point), there is a need to identify the causes of a patients pain as well as any psychiatric comorbidities that may be present. This cannot be performed by most primary care doctors and should be left to the specialists to ensure that less patients become addicted to their medication.