Archive for March 8th, 2018

Become compassionate caregivers

March 8th, 2018
Last week it was my privilege once again to attend the Lake Nona Impact Forum. One of the most important sessions was a panel discussion by some of the top thought-leaders in the medical community on the opioid addiction crisis. Speaking on this panel moderated by Dr. Sanjay Gupta were people such as Dr. Toby Cosgrove, former CEO of the Cleveland Clinic; Tim Ryan, Ohio Congressman; and Dr. Tom Mayer, Medical Director of the NFL Players Association.

Earlier in the week, Dr. David Nicholson, former Chief Executive of the National Health Service in England, and Dr. Mark Britnell, Chairman and Partner of Global Health Practice for the accounting firm KPMG, referred to the opioid crisis in the United States as a blight on our country.

What did we learn? Although we have about 4.4 percent of the world’s population, we’re consuming 80 percent or more of the world’s opioid production.

Opioid addiction is the leading cause of accidental death in the United States. From 2001 until now, opioids have produced over a trillion dollars in losses to the American economy. But money isn’t everything, or is it?

The panel agreed that the manufacturing, marketing, and distribution of these opioid products was in part attributable to pharmaceutical and distribution companies misleading the physicians and patients regarding the addictive nature of these drugs.

When OxyContin was introduced, the marketing line was, “OxyCotin is safe and controlled pain relief all day and all night.” One of the speakers pointed out that the only word in that sentence that was true was the word and.

Of course, there was some casual culpability placed on pain control requirement guidelines, compounded by the emphasis placed on the reimbursable HCAHPS scores that impact health systems and physicians financially.

We do know that 80 percent of the individuals using heroin today started with prescription drugs. I spoke with a pharmacist last week who confirmed to me that they are selling far fewer opioid prescriptions but can’t keep hypodermic needles in stock.

One sad fact that has come out of this epidemic is that only one in 10 addicted individuals seek treatment, and this is primarily because of the shame inflicted upon the users by our society. Rather than seeing addiction as a sickness, the media, and we individually, continue to portray these addicts as sub-quality human beings.

Numerous steps can be taken to help control the national tragedy, many of which were delineated during the discussion. We can, of course, stop stigmatizing the individuals who have become addicted. We can provide transparency through primary care, and according to Congressman Ryan, we can change the arcane Medicaid reimbursement of thirty days and you’re back on the street. This was the typical cure for alcoholics, but drug users need more time to rid their system of these killers.

Dr. Cosgrove of the Cleveland Clinic would like to see a publicly visible daily clock showing exactly how many individuals have overdosed and died each day in the United States from opioid abuse. We’re fast approaching the number of people killed in total during the Vietnam war each year with opioid deaths.

With less than 3percent of emergency room physicians prescribing opioid meds, we know there are numerous other ways to control pain, and we must educate all physicians as to what these methods can be.

Of course, this would not be a Nick Jacobs article if I didn’t endorse the use of mindfulness training, acupuncture, massage, biofeedback, osteopathic and chiropractic manipulation and several more world treatments that are not drug-based.

Final warning, in some states, even marijuana has been laced with fentanyl and carfentanil, originally a weapon of mass destruction and now used for elephant sedation. It’s 5,000 times as potent as a unit of heroin and instantly fatal.

Bottom line? Clean out your medicine cabinets and become compassionate caregivers. This must end.