Clinicians’ Roles in the Opioid Epidemic

Editor’s note: In this week’s must reads, we look at articles that discuss the role of clinicians in the opioid epidemic.

Last week, we posted the article, “Is this the Right Question to Ask – Who’s to Blame for the Opioid Epidemic?” In that editorial, we applauded the efforts of the Massachusetts Attorney General in seeking to fine culpability and responsibility for the opioid epidemic. A lawsuit filed by the state of Massachusetts against Purdue Pharma alleges that the company, the Sackler family (which controls Purdue), and Purdue executives misled doctors and patients about the potential addictive qualities of opioids and, in particular, OxyContin, which Purdue manufactures.

Source: U.S. Dept. of Health and Human Services

However, for those of us facing opioid overdosed patients, concerned about the opioid epidemic, and how to prevent the next patient from becoming addicted to opioids, we believe that the larger and perhaps more important question is – how are we going to fix the opioid epidemic?

Articles that we have been reading this past week provide further thought on that question of responsibility – as well as to wonder whether assigning responsibility is the right path towards ending the opioid epidemic.

Is Your Family Physician Prescribing Too Many Painkillers?

In a recent study of general practitioners in the UK, researchers found that “family doctors are signing repeat prescriptions of potentially addictive drugs such as tramadol and codeine rather than ordering pain counselling and encouraging behaviour change.”

The study also found that this was likely because family doctors are overworked. The study found that “they are too busy to help patients properly manage pain, experts have warned as the Government announced a multi-million project to tackle over-prescribing.”

Is Your Family Physician Prescribing Too Many Painkillers? #opioidepidemic Click To Tweet

Are Nurse Practitioners and Physician Assistants Prescribing Too Many Painkillers?

And, if there was a thought to think that clinicians other than doctors are to blame for the over-prescribing, a study of nurse practitioner and physician assistants found that they “are likely to abide by clinical practice guidelines for treating nonspecific acute low back pain, according to a retrospective study that examined variations in treatment between provider categories within the United States’ military health system in 2015.”

Are Nurse Practitioners and Physician Assistants Prescribing Too Many Painkillers? #opioidepidemic Click To Tweet

Hospital-based doctors have key role in battling opioid epidemic

In an editorial, Dr. Rebecca Parker writes:

Hospital-based physicians have a unique opportunity to identify innovative programs and proven practices that prevent and treat addiction in isolated pockets of the healthcare system and bring them to scale.

As a practicing emergency physician, I’ve witnessed the opioid crisis first hand. Emergency departments (ED) across the country are experts in pain management; the most common presenting symptom among ED patients is pain. In hospitals across the country, emergency departments are making strides to prevent opioid addiction by identifying alternative pain treatment options and identifying at-risk patients who need addiction treatment resources.

New legislation such as the recently passed and signed bipartisan Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) highlight and encourage these approaches.

So, what do you think? Who is best positioned to help stop the opioid epidemic?

Hospital-based doctors have key role in battling opioidepidemic Click To Tweet So, what do you think? Who is best positioned to help stop the #opioidepidemic? Click To Tweet

Leave a Comment, if You Care About Patient Safety