Doctors must help prevent opioid abuse

The most consistent and profound message emerging from the drug summit this week in Atlanta is that drug addiction is a disease.

And we’re failing at treating that disease. The Centers for Disease Control, in a recent statement, noted, “in the past decade, while the death rates for the top leading causes of death such as heart disease and cancer have decreased substantially, the death rate associated with opioid pain medication has increased markedly.”

Despite that, the resources for treating this disease fall woefully short of the need. Worse, the medical system too often enables addiction through over-prescribing powerful painkillers.

Speaking on a panel at the 2016 National Rx Drug Abuse & Heroin Summit, President Barack Obama called for investing equal resources to address the public health problem of drug abuse as are allocated to fighting it through law enforcement.

Specifically, that means increasing drug treatment, including medication assisted treatment; stepping up intervention activities to prevent drug abuse, especially among young people, including mental health services; and teaching physicians, medical students and other health-care providers how to manage pain without putting their patients at risk of deadly addiction.

The summit is organized by Operation UNITE, which Congressman Hal Rogers founded in 2003 to fight drug addiction in Eastern Kentucky. Summit sponsors include University of Kentucky Healthcare.

Obama has proposed increased federal spending in all these areas — as well as in enforcement — but the rubber can’t meet the road until Congress and the states sign on. He’s proposed $920 million in the next budget to work with states to expand access to medication-assisted treatment for opioid dependency. States that apply to participate will receive funds based on the quality of their application and the severity of the problem in their area.

Kentucky physicians, medical educators and policymakers must seize this opportunity to increase care for the epidemic they all decry.

Kentucky has one of the highest rates of overdose deaths in the nation, and there is all too much evidence of the devastation drug abuse has wrought in Kentucky. It has destroyed lives, diminished the workforce, filled up courts and prisons and caused no end of pain to families.

We know it is popular to demonize Obama in this state but, as Rogers, a Republican whose Fifth District has been devastated by drug abuse, said at the Summit, “this is a bipartisan issue, actually a non-partisan issue.”

While it’s essential to shift from a punishment to a treatment mode on drug addiction, the most efficient approach to address it is prevention, as with other diseases.

Prescription drugs remain the overwhelming source of drug abuse and addiction in this country, and this state, despite the recent spike in heroin use and deaths. Many of the prescriptions that ultimately land people in addiction are written by well-intentioned caregivers who aren’t adequately trained in pain management or in the dangers of opioids. In 2012, 259 million prescriptions for opioid pain meds were written in the U.S., enough for one bottle for every adult in the country.

The Centers for Disease Control this month issued guidelines for prescribing opioids to help stem the tide of over-prescription.

With this roadmap in hand, Kentucky’s medical schools, the Kentucky Medical Association, hospitals and other health-care providers have a good starting point for improving education among caregivers in pain management and opioid prescription.

Lexington Herald-Leader

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