The problem of opioid addiction now affects us all. It was reported that a former National Football League quarterback Erik Kramer, tried to commit suicide after his 18-year-old son, a high school quarterback, died of a heroin overdose.
The magnitude and complexity of the problem makes it truly daunting. In the year ending July 2017, a total of 66,972 people died of drug overdoses in the U.S, a 14.4% increase over the previous year. That includes more than 115 deaths from opioids per day.
These overdoses are killing Americans at a faster rate than the AIDS epidemic at its height. They are killing more than the number that dies from traffic accidents or suicides. More have died from opioids than were killed in the entire Vietnam War.
To understand how we can stop this epidemic, it helps to know how we got here. In the 1990s, drug makers convinced doctors' associations and government policymakers that new formulations of opioids such as OxyContin would not addict patients and that they were essential to control pain. Prescriptions soared.
Non-opioid Pain Management
The second step we can take to prevent opioid abuse is to address our patients' pain carefully and systematically so that they can manage without opioids. My goal is always to create for my surgery patients an experience that is devoid of pain. I follow the motto "No pain is your gain," because it's not just the best approach for my patients' health; it's the best possible way to promote my practice.
A lot of surgeons routinely send patients home with prescriptions for 30 hydrocodone/acetaminophen or oxycodone tablets. I've moved away from prescribing those drugs, along with codeine and most of the other opioids, because of my concern about addiction, says Erik Kramer.
The most dramatic report I ever received concerned not a patient but another physician, who got the license and Drug Enforcement Agency numbers of several of his colleagues. I got a report saying that I'd written about 30 prescriptions for him in 1 year. Several of us spoke to him, and he entered a rehabilitation program.
Success in managing patients' pain requires careful monitoring. I ask patients to score their pain on a 1-10 visual analogue scale. Not only does this help me analyze the situation of an individual patient, but it allows me to evaluate my success across my practice by averaging the scores of dozens of patients. And by participating in the Arthrex Surgical Outcomes System, results could be compared with those of other physicians. I challenge all physicians to take on this level of pain management.