Physicians should be given greater flexibility to prescribe opioid pain killers

Victoria Blackham | Guest Columnist

On Mar. 24, 2017, my mother, Christy, began complaining of back pain. As time passed, the dull ache she felt became agony. By the time an ambulance arrived, she was moaning and then screaming from the pain. Two EMTs quickly loaded her into the ambulance. A few hours later, several of my siblings received calls from Christy where they could barely make out her words. She was crying and pleading for help.

Later we found out the two EMTs had accused her of feigning pain to obtain prescription painkillers. She was placed in a room at the hospital where over an hour passed without receiving medical care.

The opioid crisis claims over 130 lives a day from overdoses, and one of the solutions proposed by the National Institute of Health includes “better public health surveillance.” The judgement call as to whether a patient is faking their pain could be a fatal error, as was almost the case with my mother.

Christy was found to have a 6 millimeter kidney stone, which caused a build-up of infectious fluid and sepsis.Her kidney was close to shutting down, a doctor later said.

While my experience with my mom represents an extreme example, the 18 million patients who rely on opioids to control chronic pain are also dealing with stringent requirements for opioid treatment. In 2016, the Centers for Disease Control and Prevention issued a maximum safety dosage, and urged doctors to avoid prescribing unless death is imminent. A spike in suicidal acts by veterans was found by a 2017 study from the Veterans Health Administration. Despite these signs of a major misstep in health policy, it took until 2019 for The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration to acknowledge the suicide and withdrawal risk associated with cutting doses of opioid prescriptions too quickly.

Despite these warnings, an article in Vice documented patients’ stories who say physicians are not complying with the updated recommendations. Victims of the opioid drawbacks are chronicling their struggles on social media. Evidence of excessive opioid treatment has been documented, but now the issue has swung in the opposite direction, with disastrous public health consequences.

A Quest Diagnostics survey conducted on 500 physicians during the summer of 2019 found 81 percent of those surveyed were reluctant to care for patients taking opioids for chronic pain. The misinterpreted regulations show the need for treatment to be determined on a case by case basis, especially since pain is subjective. Developing alternatives to addictive pain-relievers would be an ideal solution, but until a better treatment for chronic pain is found, the ability to treat patients should be left to the discretion of the physician.

Victoria Blackham is an economics student at the University of Rochester.