In the article “America’s War on Pain Pills is Killing Addicts and Leaving Patients in Agony”, Jacob Sullum focuses on how the policies implemented by the American government on pain drugs such as Opioids and Oxycodone is affecting patients with chronic pains and are dependent on the drugs to live a normal life. Opioids addiction among patients has caused fatalities like death owing to reckless prescription, this has in return led to a crackdown and implementation of policies to mitigate such problems. Based on the policies put in place, the patient is required to go through pill count periodically to ensure they are sticking to the doctor’s prescription. Patients who take Opioids for pain rarely become addicted to the drug. Deaths related to Opioids usually do not involve patients who accidentally get hooked while being treated for pain. Most of the Opioids related deaths normally involve people with histories of substance abuse who use different types of drugs other than Opioids.
The Opioids crisis is believed to have begun in the 1990s following the introduction of Oxycontin and the reckless prescribing which led to widespread addiction among patients and an increased number of fatalities related to opioids has made the government of America declare a public health emergency (Sullum, 2018). Increased instances of Opioids addiction has led to a crackdown on the drug and the government has restricted access to opioids by monitoring its prescription. They are now doing investigations on doctors and imposing new limits on the amount that can be prescribed. They are not only monitoring the prescription but also the circumstance the prescription can be offered. The recent crackdown has victimized a number of patients who are under the medication for pain treatment, the author narrates a story of a banking consultant, Craig, who becomes a victim of the crackdown for simply falling short of pill count of opioids. A pill count is a precaution measure that is designed to detect the abuse of narcotics or diversion to patients with the aim of ensuring that the patient does not become a drug addict of prescribed medication.
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In the authors’ narrative about the experience of Craig, he explains how he went through the various method of treatment of his back pain without success, the only optional treatment was Oxycontin. He is prescribed to take OxyContin table twice a day for his back pain which enables him to live a normal life, it is only when he was subjected to a precaution pill count by his partitionist that he was denied any further prescription by any other doctor. Even though he could account for the missing pills, his doctor would not allow him for further treatment just because he did not want to go through the process of proving he was telling the truth. This story is just an example of Americans who have been victimized by the governments' policies to control fatalities caused by addiction to the opioids drugs.
In a study, it has been found that only one percent of patients of people who took prescription pain medication before a surgery showed a sign of opioid misuse (Brat et al, 2018). It is only a small percentage of patient who takes opioids for chronic pain become addicted, despite such reassuring number the government responds to opioids epidemic is over exaggerated such that the exposure of opioids leads to addiction. This implies that the government ignores the personal, social and economic factors that make people become attracted to this drug, thus the government policies only focuses on limiting access of the drug but does not opt to solve the cause of addiction on the drugs. The intervention of the United States government to prevent the use of opioids has only made the situation dangerous, the majority of opioid-related death now involves illicit substances such as heroin and fentanyl.
According to Andrew Kolodny, an executive director of a physician for responsible opioid prescribing, the reason of an epidemic for people with the disease of opioid addiction in the United States, is because opioid has been overprescribed by physicians who were led to believe that we do not have to worry about addiction (“Centers for Disease Control and Prevention”, 2011). It has been found that the number of opioids prescription in the United States has quadrupled between 1999 and 2010 and during the same period, the annual death involved with the prescribing of opioids for pain also quadrupled from about 4300 to 18500 (Guy et al, 2017). Although the opioid prescription measured by MME per capita reduce by nearly a fifth from 2010 to 2015 the deaths involving opioids continued to increase. The rising addiction and deaths related to opioids cannot be explained with the availability of prescription, but the cause of addiction is related to patients who used the drug in the treatment of pain.
In a study, it has been found that addiction occurs in an only a small percentage of persons who are exposed to opioids even among those with pre-existing vulnerability (Volkow & McLellan, 2016). It has also been found Patients who take pain medication for some time like a month or a year their addiction rate is generally modest. It is clear that even if opioids drug is highly addictive, there is no evidence to support that treatment has caused the increased fatalities caused by addiction and even fatal overdose among patients is rear. Studies have indicated that prescribing drugs is a small player in the role of fatalities related to the drug, it was found in a study that people who were treated in the emergency room for an overdose involving prescription opioids 13 percent had chronic pain diagnosis.
In 2013 and 2014 about 85 percent of opioids related fatalities in the state involved heroin and or fentanyl, this indicates that people who get addicted to opioids are only drug addicts who can get an addiction to other drugs (Doe-Simkins & Walley, 2012). Drug policies by the government of the United States to stop the misuse of opioids are more dangerous to the users than helpful, arresting an opioid user increases the risk of drug reaction. Once a user is arrested the abstinence from the drug imposed by jail may cause a lethal repercussion after release from jail, a study has shown that someone is in risk for overdose in the two weeks after release from jail. The policy by government to limit the prescription of opioids and also deal with an illegal prescription will cause opioids users to respond by shifting to heroin and fentanyl, this will further magnify the dangerous that opioids user face as they will be dealing with drugs which are highly addictive and destructive. One policy that the government has implemented and it is promising in reducing the number of deaths that are related to opioids is the easier access to naloxone which is an overdose-reversing opioid antagonist that can be administered through injection or nasal spray.
In my opinion, the government’s attempts in limiting prescription of pain medication affects the lifestyle of many patients suffering from pain, while at the same time the government policy to limit prescription has a small impact on the death related to opioid misuses. It is clear that addiction for the opioid drug is not necessarily related to patients who are prescribed to take medication for treatment for pain but mostly those who are addicted opioids are people who are addicted to drug substance opioids being one of them.
Doctors must be held accountable for overprescribing opioids but in my own opinion, this should not give them chance to harass legit patients who are undergoing treatment. Many patients in America are victimized by government policy to limit prescription of opioids while at the same time it is only a small percentage of patients who are prescribed to the drug are involved in deaths related. The precaution policy to subject patients to periodical pill count is an effective way to ensure that patients do not get in habits that will cause them to be addicted to the drug, though it is also important for the government to react to social, economic and other factors that make people to illegally use the drug.
In conclusion, the war on opioid use by the government of United States should be done in a way that ensures patients who require treatment are not victimized by policies enforced to eliminate the number of deaths that are related to opioids. Policies implemented by government should be focuses on how to control the addiction of this drug in a way that it will no affect patients who rely on the drug to have a normal lifestyle.
References
Brat, G. A., Agniel, D., Beam, A., Yorkgitis, B., Bicket, M., Homer, M., ... & Kohane, I. (2018). Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study. bmj , 360 , j5790.
Centers for Disease Control and Prevention (CDC. (2011). Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. MMWR. Morbidity and mortality weekly report , 60 (43), 1487.
Doe-Simkins, M., & Walley, A. Y. (2012). Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution: MDPH Naloxone pilot project Core Competencies.
Guy, J. G., Zhang, K., Bohm, M. K., Losby, J., Lewis, B., Young, R., ... & Dowell, D. (2017). Vital signs: changes in opioid prescribing in the United States, 2006-2015. MMWR. Morbidity and mortality weekly report , 66 (26), 697-704.
Sullum, J. (2018). America’s War on Pain Pills is Killing Addicts and Leaving Patients in Agony. Reason Magazine .
Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine , 374 (13), 1253-1263.
