The Fed's New 'War On Drugs': Obama Proposes $1.1 Billion To Expand Care For Opioid Addicts
By Melinda Carstensen Published April 14, 2016
Click For Fox News Health
Stock
Amid a prescription opioid abuse and heroin use epidemic largely fueled by overprescribing among doctors, President Obama has suggested allocating $1.1 billion to expand affected individuals’ access to care— a proposal that has garnered bipartisan support. Although some experts question whether throwing money at the issue will be enough, many believe that, if used properly, the funding has the potential to save lives.
According to the Centers for Disease Control and Prevention (CDC), nearly half a million Americans died from drug overdoses between 2000 and 2014. Opioid overdose deaths, including those from heroin, hit record highs in 2014 and saw a 14 percent increase in only one year.
Baltimore City Health Commissioner Dr. Leana Wen, who has worked as an emergency room doctor in one of the nation’s opioid addiction hotspots, said the proposal signals a shift in thinking about addiction as an individual’s problem best controlled with law enforcement, to a chronic medical condition like diabetes or heart disease that can be prevented and treated.
“That science has been around for decades, and society’s perception has caught up,” Wen told FoxNews.com.
“A pill for every pain”
In 2014, 259 million opioids— or enough for every American adult— were prescribed, according to the CDC. The most commonly prescribed opioid pain relievers were natural or semi-synthetic opioids like oxycodone and hydrocodone, which are involved in the most overdose deaths among opioids. The CDC recorded 813 more deaths, a 9 percent increase, from these types of opioids in 2014 than 2013.
Over the last decade, overall deaths resulting from opioid abuse and abuse of illegal narcotics like heroin have quadrupled.
A study published in the November 2015 issue of the journal Proceedings of the National Academy of Sciences suggested overdoses from drugs like opioids is one of the main reasons why deaths of middle-age white Americans are rising while the overall death rate in the United States has fallen.
“There are people in suburban and rural areas who are dying of overdose,” Wen said. “Unfortunately, it’s taken this level of people dying to get us to where we are, but I do think a sea of change is occurring, and we are seeing how overdose kills.”
Although multiple factors have contributed to the epidemic, Wen and other experts have argued that a culture of “a pill for every pain” has played a key role.
Dr. Melinda Campopiano, a medical officer at the Substance Abuse and Mental Health Services Administration (SAMHSA), who both prescribes opioids and treats patients who have become addicted to them, said when she was in medical school in the ’90s, professors taught students using the sickest of patients.
That approach may have skewed the risk-benefit factor for stronger drugs like opioids versus over-the-counter medication like nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, she said.
An assumption at the time that pain was undertreated in America overall led many doctors to readily prescribe opioids as it was.
Campopiano added that the trend of overprescribing opioids may also have emerged from a well-intentioned effort to standardize care across the board. At that point, evidence emerged that pain in minorities particularly was being undertreated—a bias that data suggest still affects minority and less-wealthy patients today.
“You want professionals to overcome their inherent biases, but you can’t count on that, so by being systematic in treating pain, the intention was to eliminate the suffering that was the result of racial and ethnic biases that people had,” Campopiano told FoxNews.com.
That systematic approach persisted through the 1990s and 2000s, and was accompanied by a push from the federal government for doctors to better address their patients’ pain in its “Pain as the Fifth Vital Sign” campaign.
Researchers at Brandeis University, New York University and others, argued in the January 2015 edition of The Annual Review of Public Health that Big Pharma’s campaign throughout those decades downplayed the risks of long-term opioid abuse and encouraged their use. In 2007, OxyContin producer Purdue Pharma paid $634.5 million in fines for harmful advertising of the drug.
Data shows opioids are among the most addictive drugs on the market. Although experts dispute their efficacy for chronic pain and there’s no perfect pill for every type of pain, the drugs change the way the brain and nervous system respond to pain, generating a euphoric or relaxing effect. But the longer and more frequently an individual takes an opioid, the more they’ll need to take to get the same sense of relief.
Despite increased public knowledge of opioids’ risks, ideals pushed by Big Pharma and the federal government still persist in doctors’ offices. All too often, doctors don’t offer patients alternatives to opioid prescriptions, nor do they always ask about their mental health or addiction history, Campopiano said. Patients want to get better and trust their doctors, so they often don’t challenge their judgment.
“A big downfall in provider education is we don’t teach health professionals to ask about and address mental health and substance use disorder issues consistently and effectively,” Campopiano said. “On that side of the issue, I would include informed consent of patients so that patients have the opportunity to make fully informed decisions about their treatment options.”
