We have all heard about the Sacklers and may have even been enraged after watching Dopesick on Hulu. How does this happen in the USA?
The dark side of capitalism is that often many people will find a way to make a product, leverage others and make billions while harming others. Those others may have wittingly or unwittingly caused the harm as was the case with Opioids.
Sure, the Opioid crisis could not have happened without medical doctors being willing the recommend them with their limited knowledge of chronic pain. Their primary care tools are limited to pills or referrals to medical specialists who are more likely to look for invasive or medication methods of pain control instead of looking for the cause of why you hurt. This has been worsened by the weakening of primary care by hospitals that have purchased physicians’ practices and profit from the segmentation of care. Clearly what is often missing in pain care is a holistic approach to care commonly used by chiropractors. Suggesting doctors just use a less harmful pill does not change the fact that pills don’t solve problems, they merely make them more chronic and increase costs and risks while we age. If you want proof, hospital systems were losing money due to the loss of elective surgeries during the Covid-19 shutdowns. Many of these were for joint replacements that could have been avoided had those patients gotten better advice from their providers years earlier. Do we need more evidence when the data from years of medication use shows that it enhanced the business of costly and risky joint replacement after people ignored their problems for years?
While I could bore you with all of this, right now the CDC is writing their document and allowing public comment on their guidelines for opioids. I have personally left my comments and you should as well.
There would be a much smaller opioid problem if medical doctors would have been referring their musculoskeletal pain patients out for more appropriate care rather than treating a problem they did not understand with pain medication or sending them out to other specialists for more tests, procedures, and other things that did not solve their problems. Pain management as a profession would rather perform a procedure on you instead of helping you solve the mechanism behind why you hurt.
Insurers have raised the cost of going to the chiropractor or physical therapist and interfered with your access to pre-cert programs that do nothing to reduce or improve care. The governments have also allowed insurers to set up tiered networks which reduce choice and access as well. If you’re not angered by this nonsense, you should be since fixing the opioid crisis is about access and improving incentives for providers who can do the work while addressing the important fact that insurers have created a crazy maze to access the care of effective and safer healthcare providers who are more cost-effective.
The NY times recently reported on this and offers links to comment on the document yourself.
C.D.C. Proposes New Guidelines for Treating Pain, Including Opioid Use
The agency threw out previously recommended limits on doses but encouraged “nonopioid therapies” wherever possible.
By Jan Hoffman Feb. 10, 2022
The federal government on Thursday proposed new guidelines for prescribing opioid painkillers that remove its previous recommended ceilings on doses for chronic pain patients and instead encourage doctors to use their best judgment.
But the overall thrust of the recommendations was that doctors should first turn to “nonopioid therapies” for both chronic and acute pain, including prescription medications like gabapentin and over-the-counter ones like ibuprofen, as well as physical therapy, massage, and acupuncture.
Though still in draft form, the 12 recommendations, issued by the Centers for Disease Control and Prevention, are the first comprehensive revisions of the agency’s opioid prescribing guidelines since 2016. They walk a fine line between embracing the need for doctors to prescribe opioids to alleviate some cases of severe pain while guarding against exposing patients to the well-documented perils of opioids.