Dr. Manny: 5 steps Trump can take to help curb the opioid epidemic in America
Before Donald Trump became president-elect of the United States, I declared my support for his proposed efforts to help curb the tragic opioid abuse epidemic our nation is facing today. This week, the Centers for Disease Control and Prevention (CDC) released new data that suggests this issue is becoming increasingly pressing.
More Americans died of drug overdose in 2015 than ever before, the CDC announced Thursday. In a single year, 50,000 Americans lost their lives due to the epidemic, which has largely been fueled by doctors overprescribing painkillers and patients’ skyrocketing abuse of heroin— an illicit drug that is largely making its way across the United States border and into Americans’ hands.
The CDC found that heroin fatalities soared by 23 percent from 2014-2015, reaching nearly 13,000 deaths— only slightly higher than the number of gun homicides. Illicit fentanyl, the drug blamed in the late pop icon Prince’s death, saw the biggest gain in abuse rates: Its use rose by 73 percent in the one-year period, claiming 9,580 lives. Meanwhile, use of opioids saw the biggest increase, but led to the most deaths in 2015, as drugs such as Oxycontin and Vicodin killed 17,536 Americans last year— a 4 percent increase from 2014.
As I said back in May, I think President-elect Trump will be the best leader to help address this epidemic, but it will take the cooperation of physicians, pharmaceutical companies, health care workers, church leaders and patients themselves to help save innocent lives. However, I believe there are certain steps the Trump administration should— and feasibly can— take to get a handle on the issue. The recently passed bipartisan 21st Century Cures Act, which allocates $1 billion toward addressing opioid epidemic, can help make these things possible.
1.) Prioritize a new model for health care providers to assess pain
In the 1990s, the Centers for Medicare and Medicaid Services began using a regulatory mandate in the form of what’s called a pain intensity scale, which required doctors ask their patients to rate their pain on a scale of 1 to 10. A rating of “0” indicated no pain, “4” indicated the pain was distressing and “10” indicated the worst pain. Although this concrete scale had good intentions because it sought to address what regulators then saw as under-treatment of pain, many experts now agree the scale has led to far too many patients being addicted to painkillers rather than healed from the injuries that caused the pain in the first place. After all, allowing patients to self-report pain when taking highly addictive drugs can be dangerous. Moving forward, it will be very important that whoever is heading this effort in the White House does away with this regulatory scale and create a new model for assessing pain. In the end, doctors need better tools to effectively and safely determine who needs prescription painkillers and who can do without them.
2.) Implement electronic monitoring for prescription drug points of purchase
If a doctor gives her patient a prescription for Vicodin after he hurts his back, and that person goes to pharmacy A to fill it, but then goes across town to another doctor who calls for a prescription at pharmacy B, he should not be allowed to fill that second prescription before his doctor clears it and he has completed the first recommended dose. Ultimately, we need a central database that monitors narcotics to curb prescription shopping and inadvertent dispensing among chains that do not talk to each other.
3.) Entice the pharmaceutical industry to look for alternatives for pain management
Contrary to what many doctors have been trained to believe, narcotics are not the only avenue for addressing pain. New, promising drugs are emerging in this field that offer similar benefits without the risk of addiction. The CDC has issued advice on this matter, pointing out alternatives for common ailments like lower back pain, osteoarthritis and fibromyalgia. Alternatives to NSAIDs such as intravenous acetaminophen also may offer promise for a non-addictive way to address pain.
4.) Focus on patient treatment, as well as prevention and education
The CDC has recognized that overprescribing has fueled the current epidemic, but we are dealing with an enormous mental health crisis in this country as well. As patients become addicted to their prescription opioids, but are then cut off from their doctors, many turn to the streets for cheaper, more accessible illicit drugs like heroin and fentanyl. For many patients, the euphoric effects of fentanyl are too extreme to resist. According to the CDC, the synthetic drug is 50 to 100 times more potent than morphine. Sometimes, people mix the drug with heroin to increase its intensity, and each time they take the drug they need more to get the same level of high they did before. It’s time health officials made these risks clearer and for communities to put a greater emphasis on treatment, prevention and education so more lives can be saved. Some community initiatives, like those in Maryland, have increased access to naloxone, the anti-overdose drug that experts say can increase survival rates.
5.) Work with drug enforcement agencies and border control to halt the import of illicit drugs
According to the Drug Enforcement Administration (DEA), heroin is processed from morphine and drawn from poppy plants grown in Southeast and Southwest Asia, Mexico and Colombia. Meanwhile, the DEA has spoken out about halting the import of fentanyl to the U.S. Quick to produce and profitable, fentanyl may enter the U.S. through Mexican cartels who buy large quantities of the drug from China. While hospitals and physicians should make changes in their practice to curb overprescribing painkillers, the government needs to protect our border and prevent these illicit drugs from continuing to claim the lives of mothers, fathers, children, neighbors and teachers at these alarming rates.
The Associated Press contributed to this report.
Dr. Manny Alvarez serves as Fox News Channel’s senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. Click here for more information on Dr. Manny’s work with Hackensack University Medical Center. Visit AskDrManny.com for more.
Filed under: General Problems
Bull SHIT… people are dying because doctors are taking opioids away from patients who need them and these pain sufferers are now turning to the streets for unsupervised pain relief. If these mental amoeba keep taking medications away from people in pain, then more honest suffering people will go to the streets with more and more frequency, inevitably causing many more overdose death. If anyone really thinks that Donald J Trump is the answer to the growing overdose death epidemic then they are Mentally unfit to be a human being. This guy would call it a Social Security savings program if every pain sufferer in the US died from OD’S and declare himself a Terrific President for coming up with the idea to kill us all off.
TO POPS”;;;;;; were all ready being killed off,,,it hasn’t took a Trump,,,to kill us,,,it took prohibitionist,,and the dea,,,mary
Great reply’s by all and might I add, and how about a movement to shut down the “spinal epidural shot mills” that are springing up everywhere?
jmo,,,good read recommended Mr.Lawhern,,maryw
I just wrote drs.manny,,,,seriously, the stupidity of this mans brain is soo evident…why would u ask the person who is actually thee only one who can physical feel his own pain,,why asked them essentially,,,how much does it hurt,,because they are thee only ones who can feel it,,,dahhhh,,,Another one who’s delusion of grandeur effectively makes him think he is some sort psychic,,,,,and can read people minds,,,,that is truly crazy and stupidity,,coming out of a so-called DOCTOR,,,,,WOW,,,,,maryw
Intravenous Tylenol??? This jackass seriously has no clue … Let’s continue punishing legitimate pain patients who are using LEGAL means of reducing their pain. Yeah, that’s been working for the past few years …
This article is for the most part complete nonsense reflecting an anti-opioid bias uninformed by research. Reality is that risk of prescription drug abuse among chronic pain patients is well under 10%. And even when medication abuse occurs, it is NOT and never has been a consequence of over-prescription among people whose pain is long term and properly diagnosed. Likewise when pain patients later become involved with street drugs, the most plausible explanation is that they have been under-treated for their pain by doctors, and stigmatized by their families and communities.
The great majority of opioid overdose deaths are due not to drugs prescribed for actual patients, but rather to a combination of street drugs like heroin and fentanil, and diversion of prescription drugs by theft or fraud. Much of the increasing problem with heroin was a direct outgrowth of changing the formulation of OxyContin to make it abuse resistant, in 2011. OxyContin use dropped like a stone. Drug abusers switched from safe pills they could buy on the street, to unsafe injectable drugs that were cheaper and more available.
At present, there is no viable alternative to self-reporting of pain levels as a measure for treatment effectiveness. And tests for prior non-prescription opioid use are entirely and artificially much too expensive. The latter issue can be solved with a little research to reduce false positives and automate the tests.
As a counterpoint to the crap being spewed by Fox News, I recommend a paper by three physicians who actually understand the issues in treatment of chronic pain with opioids. See “Neat, Plausible, and Generally Wrong: A Response to the CDC Recommendations for Chronic Opioid Use” at https://medium.com/@stmartin/neat-plausible-and-generally-wrong-a-response-to-the-cdc-recommendations-for-chronic-opioid-use-5c9d9d319f71#.qy2h9z4cu .
You have really looked into what you have just said. You are a breath of fresh air on this topic .
thank you
At what point will a doctor stand up to idiots like this guy.I mean his shear stupidity in his comment,,’why ask the humanbeing who is actually forced endureing the physical pain,,when no-one else can factually feel that physical pain,,why ask the person actually endureing physical pain how much it physical hurts,,is like saying fire isn’t hot,,and will burn people,,Its just a fact,,,,Hes an idiot,,,obviously,,,and if anyone believe a word out of his mouth,,is just as much a idiot,,Another arrogant idiot who thinks he has the rite to decide how much we are to suffer in physical pain,,when it is factually impossible for anyone to physically feel the physical pain of another,,,,maryw