Why America Can’t Kick Its Painkiller Problem

Published in Time Magazine, this story was written by Massimo Calabresi and highlights the effects of the opioid epidemic and the downstream impact it has had on the small communities of our country.

The story focuses on Scott County Indiana, a small rural community 20 miles from the Kentucky border, where they are experiencing the worst HIV outbreak in the state’s history. In January 2015, there were 8 new confirmed cases of HIV in the county and that number has now grown to 166 as of June 2015. Just like the catalyst that helped set off the HIV epidemic in the 1980’s, the culprit is once again opioid drugs. But instead of the source being international heroin smugglers as it was in the 80’s, the drug is now prescription Opana (Endo Pharmaceuticals) that is prescribed by physicians and black marketed by those looking to make a few bucks by peddling street drugs that addicted residents are shooting intravenously in order to maximize the effect per dollar spent.

The NIH estimates that of the 10 million or so Americans who take opioids for chronic pain, over 2 million are in danger of turning to the black market for these drugs as a pain relief strategy or simply to keep the symptoms of withdrawal at bay for just one more day. Additionally, 80% of current heroin addicts say they first developed the disease of addiction after being prescribed opioid painkillers from a physician as addiction and abuse ravage communities across our country. Heroin deaths have more than doubled to 8,000 per year since 2010 and 46 Americans die everyday from prescription opioid overdoses.

How has this happened so rapidly? The answer is a combination of potentially overzealous marketing by pharma companies, a strong desire to relieve suffering by the FDA and JCAHO, and the production of inadequate clinical studies that were accepted by the medical provider population. While none of these factors alone could have caused the situation we find ourselves in now, the combined forces of all three has led to a perfect storm and resulted in consequences no one could have foreseen at the time.

After analyzing tens of millions of health plan lives, the problems fueling this economic and societal plague are quite clear: providers are not well educated as to appropriate indications for using these dangerous drugs, patients are not evaluated for possible comorbid diagnoses that precipitate poor outcomes, other useful therapeutic interventions are not performed in a timely manner, providers are not measuring functional outcomes from these therapies (nor are they given the tools to reverse the course they have put in place), and few other alternative therapies are being used that more effectively treat chronic pain and all its behavioral and adaptive counterparts. Developing these core protocols is what we do at axial healthcare.

To sum this up and address meaningful solutions, axialHealthcare CEO, John J. Donahue, was quoted on this topic yesterday during a New York Health Care Forum:
“This opioid abuse epidemic is a U.S. Health System failure and human tragedy on par with some of the most horrendous and threatening scourges to afflict our nation. With the same precision that a virus can be proven to cause a specific disease, this opioid crisis is a direct byproduct of dysfunctional acute and chronic pain care. It can by entirely avoided through clinical evidence-based pain care delivered by equipped and accountable practitioners who coordinate care, engage and support their patients. This is axialHealthcare’s mission and our pain care tools are driving positive outcomes for our health insurer partners everyday.”

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