Although it's impossible to escape news of the opioid epidemic, we haven't heard the whole story.
At Progressive Care, I've met patients from all walks of life and witnessed firsthand the caustic consequences of opioid misuse and abuse. The opioid epidemic is a deeply emotional and complicated issue
In this three-part series, we'll explore the causes, obstacles, and solutions to the over-prescribing of opioid medications. If you missed it, start with Part 1: How Opioid Medication Became the Only Prescribed Pain Treatment.
Join us as Progressive Care, along with their wholly owned subsidiary, PharmCo, LLC, leads the charge to develop actionable solutions along with pain management alternatives to opioids.
Jane is suffering from an injury that resulted in surgical complications and has an incurable, pain-generating problem. For Jane, the pain is real, chronic, and severe. It is likely that she has developed a high tolerance, dependence, and addiction to opioids because of her medical condition.
If opiates are bad, then cutting them off would seem to be the logical solution.
However, cutting off opioid pain medication without an action plan in place typically results in life threatening withdrawal, as Jane's pain is amplified 1,000 times. Patients like Jane feel pain as well as abandonment, hopelessness, and despair.
Cutting opioid medication off completely can be cruel and harmful to the patient, due to dependency and addiction.
Opioid dependency and addiction are different concepts that go hand in hand. Dependency occurs when the patient lacks basic functionality without medication. Addiction is a mental and physical response where the patient “needs” the medication or substance, regardless of whether there is an underlying condition or not.
Taken by themselves, each state has relatively common solutions. Dependency would entail a managed withdrawal and introduction of effective medicinal alternatives. Addiction would require rehabilitation. However, dependence and addiction often exist at the same time. Most patients who are opioid dependent are also addicted, which is a much more difficult situation to solve.
Opioid addiction amplifies underlying pain during any withdrawal period, making it difficult to assess how much pain is derived from a medical condition versus the effects of addiction, or if the patient even needs ongoing pain management. Addiction also makes patients extremely resistant to alternatives as the brain craves the “high”-inducing effects of the opiate, which other forms of treatment will not provide.
To effectively manage pain for an addicted and dependent patient, the addiction must be addressed first. Removing an addiction is an excruciating process to start and a lengthy process to manage. For many patients, sobriety is a day-to-day situation as life events can trigger a return to addictive behavior.
More dedicated addiction treatment is necessary. Addiction can be treated in inpatient and outpatient settings. Counseling, support groups, medications, home health visits, and clinical services are all covered under the Affordable Care Act. It is important for these services to be more readily available and for the stigma of addiction to be removed. Addiction could happen to anyone and seeking treatment does not lessen the value of a person.
To come out on the other side of addiction, a person must be willing to endure the struggle and the pain that comes along with it. For this, support is imperative, and the medical community, doctors and pharmacies must prepare to provide support, and not simply reject patients because the addiction makes them difficult to manage.
Right now, many patients believe that opiates are their only option for pain relief. Opiates are not the only option and the alternatives may work even better over time.
Money is the biggest impediment to success against opioid addiction. Many patients lack addiction treatment coverage and even with coverage, out-of-pocket costs are significant. Many insurance carriers do not cover alternative pain therapies.
Alternative pain treatments are typically costlier than opiates. While opioid coverage continues, many alternative therapies are either denied initially by insurance companies or recouped after the fact during audit. This prevents many pharmacies and doctors from even attempting to try a more nuanced pain management approach.
Solutions require investment. The cost of putting an end to the country’s opioid crisis will be extremely high. Insurance carriers, drug manufacturers, and government agencies must find a way to fund solutions that provide results. Doctors, rehab facilities, charitable organizations, support groups, and pharmacies will all need a commitment from the community and sources of capital to do the work and accomplish the mission.
There is still an uphill battle to be fought, as the country attempts to decrease health care costs overall. However, it must be said that alternative medicinal pain management solutions are significantly cheaper than hospital, rehab, and societal costs that result from patients who are not afforded effective options.
At Progressive Care and PharmCo, we're working on providing support to patients and doctors through our innovative services and new education program.