At a time when the medical community is taking major heat for its alleged role in the current opioid crisis facing the country, healthcare professionals are still on the frontlines of the fight against addiction. This article discusses some of the insights medical professionals have gained about the nature of the crisis.
Addiction Treatment Front Lines
Addiction treatment is full of stories. The stories shared are often from the point of view of the addicts. Yet the stories of the clinical providers who are sometimes ill-equipped to handle the crisis are just as compelling.
That is in part because clinicians have been taking criticism for their role in the opioid crisis. However, pharmaceutical companies downplayed the addictive nature of these medications, and a scathing expose in
The New Yorker led to Congressional hearings for a pharmaceutical industry that succeeded in marketing opioids to clinicians by downplaying their addictive nature. The author interviewed a pharmaceutical company insider who said OxyContin sales reps were given talking points to counteract physician inquires about addiction with,
‘The delivery system is believed to reduce the abuse liability of the drug.”
Ever since these damning findings have come out, drug companies like Purdue have been settling lawsuits in the millions. But where does that leave clinicians who are often unprepared to handle the manipulative and sometimes pressure-filled communications with opioid-addicted patients?
Handling an angry and drug-seeking patient places undue strain on clinicians.
Take the case of an internal medicine physician who saw a patient with a history of headaches. The story was covered in a
New York Times magazine supplement. In it, the physician recounted his first experience with an opioid-addicted patient and his struggles to determine the best course of treatment. The patient exhibited drug-seeking red flags but also used abusive and coercive behaviors in a variety of clinical settings. In many of these instances, it seemed busy and stressed clinicians prescribed opioids as a way to placate a frustrated and screaming patient, just to get her out of their emergency rooms. The author called it “mutually assured destruction.”
Another
New York Times article sought to share the stories of addiction treatment providers and concluded there are trends affecting clinicians and patients in the American healthcare system:
- First, we do not completely understand addiction. Why does one patient become opioid addicted after surgery and another does not? Each case is individualized, making addiction treatment even more challenging.
- There are systemic barriers to accessing addiction treatment, particularly in rural areas where the problem is the most prevalent. Mental health treatment under Medicaid is woefully inadequate; funding is tight and more research needs to be done.
- The system perpetuates the myth that surgery should be pain-free. Patients expect opioids and if their pain is not effectively managed, they could respond negatively to the patient satisfaction surveys that help regulate the amount of reimbursement that hospitals receive.
- Finally, clinicians still stigmatize addiction, despite the fact that it has been classified as a disease disorder like cancer or diabetes. Even addiction treatment centers sometimes force patients into withdrawal without prescribing clinically effective medications for managing symptoms.
The clinicians on the front lines of addiction treatment are facing some of the most frustrating and difficult patients and treatment is individualized and long-term. The resource investment is both labor-intensive and financially high, but clinicians say the rewards are always worth it.
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