19 Mar Prescription Drug Addiction: Who’s to Blame? – Part 1
Prescription painkiller addiction has become one of the fastest growing addictions in the country. Vicodin, Percocet and OxyContin have replaced dependence on illicit street drugs in some circles. In order to get these drugs, users should have a prescription, which means they must see a doctor. But doctors aren’t the only ones involved in the transaction. Patients are seeking, even demanding, prescription painkillers in ever-greater numbers and the black market provides access when a prescription cannot be obtained. j
Who is to blame for the prescription painkiller addiction epidemic that is sweeping our country? Is it the doctors who over-prescribe? Do we point the finger at drug companies who push their products while minimizing the potential risks and side effects? Is it the clinics and hospitals that often pit patient satisfaction against physicians’ ethics? Or should the blame fall on the patients’ desperate cravings for a pill that will cure their ills and take away their pains?
There is no easy answer, though it is a problem worth examining. What we now have in the United States is a drug-desiring population coupled with legal purveyors (physicians) of the drugs. Add to the mix drug companies who want to sell drugs plus hospitals and clinics that thrive on patient satisfaction. Unlike the corner drug dealer who can sell to or deny whomever he wishes, the doctor can face low ratings for denying his clients. This can threaten job security and mobility.
But how far does a doctor go when trying to satisfy the desires of a patient when those desires are patently harmful? At what point must the doctor remember the “do no harm” clause and recognize the damage that these drugs have the potential to inflict upon users? And at what point must patients desire their own good and exercise adult responsibility? Rectifying the overuse and misuse of prescription painkillers will necessarily involve an investigation of these root causes—institutionally and individually.
It would be one thing if the doctor only faced the consequences of a few dissatisfied patients who were unable to secure their fix from an ethical doctor. However, the career consequences can be graver than that. Hospital administrators are often unsympathetic to unfavorable reviews. For a doctor, it may be one thing to lose a few drug-seeking, addict patients; it is another thing to face potential career-ending consequences.
Another problem pervades the medical world and the prescription of narcotics for pain. Doctors are often under-trained in true pain management. For the general public this may be hard to fathom. We generally expect doctors to know everything there is to know about disease, pain, the body and any drug that comes onto the market. In reality, doctors often prescribe opioids because they provide the quick fix the patient is seeking and can handle the issue in the short span of time health insurance companies allot doctors for working with patients. Pain management that focuses on non-drug treatments or that minimize pharmacological therapies is a time consuming process of trial and error. Many doctors don’t have the knowledge and patients don’t have the patience.
Flawed patient perceptions are also contributing to the problem. In the United States, there is a general assumption that if a doctor recommends it or prescribes it, it must be safe. It is also commonly assumed that if it’s a pharmaceutical, it’s safe. The purpose of this article is not to call into question the knowledge or expertise of doctors as much as it is to help the reader understand that this is not a perfect system. While prescription painkillers can be beneficial and even necessary in the management of pain, they also lead countless individuals into life-controlling addictions every year. Their use must be approached with caution and it is up to patients to take responsibility and do their share of the research as they discuss pain management options with their doctors.
Pain meds need not be demonized. The answer to the problem is not to simply eliminate prescription painkillers, though some patients will personally deem this the safer track. They will refuse pain meds altogether out of fear of addictive side effects or a desire to simply tough it out. This is not always a wise option; severe pain that is not managed can cause undue stress to the body and impede the recovery process. Taking a pain medication as directed can help avoid adverse consequences. While even in prescribed doses, physical dependence upon pain meds is not uncommon, this does not immediately signal an addiction. It can, however, lead to one if proper precautions are not taken or the drug is not used in its intended manner.
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