In rush to act on opioids, don’t overlook those in pain

In Feature by admin

By Dr. Jed Delmore, Reprinted from Kansas.com, May 11, 2018

Opioids are all over the news these days. Insurers and regulators are discussing limits on prescriptions, and politicians are pointing fingers.

Though action is needed to curb the misuse of opioids and help those struggling with addictions, we also need to respect and care for people in real pain. And to realize that one-size-fits-all solutions can do harm.

The Medical Society of Sedgwick County recently held a panel discussion for its members on opioid use in Kansas. Panelists were Greg Lakin, an addiction specialist and the state’s chief medical officer; Joe Davison, a Wichita family physician and member of the advisory board of K-TRACS, the state’s prescription-monitoring program; and Daniel Warren, a faculty member at the KU School of Medicine-Wichita specializing in substance abuse.

The panelists noted how Kansas has not experienced the same level of opioid abuse and overdoses as many other states, including several of our neighbors. The drug overdose death rate in Kansas was 11.1 per 100,000 people in 2016, according to the Centers for Disease Control. That was among the lowest rates in the nation.

Opioid overdose deaths in Kansas also have declined in recent years, as has the percentage of prescriptions that are opioids.

It’s also important to note that most of the opioid overdose deaths in the past few years were caused by synthetic opioids, such as fentanyl. And the vast majority of the people abusing opioids don’t get them from their physician.

That’s not to say that the problem isn’t serious. The misuse of opioids is destroying lives and wrecking families.

And contrary to what some may assume, those dying from opioid and heroin overdoses include many people in their 50s and 60s who hold jobs.

“It’s not just the young, careless and wild,” Lakin told Medical Society members.

But in the rush to act, we must not overlook or dismiss those who need help with pain.

As a gynecologic oncologist, I have many patients who experience severe pain, particularly as they recover from major surgery. Family physicians also have patients struggling with chronic, sometimes debilitating pain.

For some surgeries and patients, alternative medications – such as a combination of Tylenol and ibuprofen — can be just as effective as opioids. But for other patients, arbitrary limits on medications can make their difficult lives even harder.

I’m grateful that our state lawmakers and Gov. Jeff Colyer have been proactive in working with physicians and others on policies that make sense for Kansas.

The governor formed a task force, headed by Lakin, to address substance abuse disorders. The Kansas Medical Society and the Kansas Hospital Association also created a joint task force on opioid use.

These groups are carefully studying the opioid issue and are seeking evidence-based solutions.

Action is needed. But it needs to be help patients not harm them.