I get it. We have all just lost a guiding artistic light, and it might have something to do with a suspected overdose. Now we want to fix the problem, so “ban opioids” are starting to appear in my social media feeds. We can’t bring anyone back, but we can figure out the root of this problem.
I am in favor of what might help addicts, but in this case, fixing a problem is not as easy as banning something. There is a deeper problem, and opioid abuse is just one symptom. If you make opioids harder to obtain, you stigmatize my community, those with invisible illnesses and chronic pain. You make treatment and help even harder for us to obtain. We are so often seen as drug-seeking addicts.
People with chronic pain and severe health conditions often need opioids. The harmful myth is that everyone who pops painkillers is an addict. But many studies say that chronic pain patients are not the majority of those who become addicted; the pills often don’t give a “buzz” when you’re just trying to fight to function. Instead, they usually just help with sleep. In fact, there’s a huge difference between needing a pill to function and being addicted.
Dr. Howard Fields, professor of neurology at University of California, San Francisco, is quoted on “Here and Now” WBUR’s blog:
The greater problem is that there’s a huge reluctance in general of physicians to prescribe adequate medication for people who really are in pain and have a very low risk of becoming addicted. That’s the big problem. I think if you read the actual epidemiological data and the data from insurance companies and health organizations, it suggests that the vast majority of people are undertreated for their pain and I think that that’s in part due to the scare of overdosing and having the drugs diverted and making somebody who never was an addict and never had a drug abuse problem into an addict. My position on that is that’s very rare. I know people are being undertreated for pain. Opioids are the most effective pain relievers we now have. You want to use them optimally, but you want to use them when they’re necessary.
There are very few comprehensive pain clinics, especially for chronic pain.
Doctors may prescribe opioids too often for minor injuries that get in the wrong hands (this is called “diversion”), but the problem is not chronic pain patients, who manage their meds and know where they are. The problem is the 15-minute doctor visit, which is driven by a healthcare system more concerned with the bottom line that our health. “You hurt your shoulder? Here’s a scrip, I gotta go.” I believe there would be fewer unnecessary opioid prescriptions if we had a comprehensive healthcare system that was open to everyone.
If we had comprehensive healthcare reform, someone who did develop an addiction to opioids, they could get help—but right now rehab is also out of reach for many people without insurance. (It’s true, not genius singers. They could afford to go. Addiction is so hard and hearbreaking and stigmatized for so many reasons. And it often starts because people are in chronic pain and not medicated effectively, so they turn to a cocktail of their own creation.)
When someone dies of a drug overdose, don’t say that opioids are the problem, because in a country with a broken healthcare system, those drugs are one of the few tools for survival that people in chronic pain have to get through the day. Opioid abuse is a symptom of a deeper problem, and that is our healthcare system.