Feeling the Pain

Opioid epidemic

The opioid addiction crisis strangling America’s healthcare system has the potential to cripple service delivery by hospitals and providers of all sizes in all regions. Stop them cold in their tracks. Sap resources at rates never before seen in modern healthcare. This particular disease, like so many others, knows no boundaries. Rich. Poor. Old. Young. Black. White. When a wave of opioid-induced healthcare issues overwhelms communities, healthcare at all levels suffers, as does the fabric of the community. The toll is often incalculable.

Look to the horrible experiences of New Hampshire and Vermont — two states which pride themselves on self-reliance. Both are still struggling. The OxyContin, it seems, has been replaced by something more potent, less costly, and more readily available — heroin.

I asked a physician friend of mine recently what was going on. Painkillers, I opined, have been around for years. So have opioids. Why is this problem now seeming so urgent and out of control? “Lots of reasons,” he said. “Virtually all preventable.”

As someone who has been on a small community hospital board for nearly 15 years, I have to wonder if some of the increase in the addiction rates is the direct result of the pressure we’ve put on hospitals and physicians. Insurance companies increasingly reimburse based in part on patient satisfaction. One of the categories of satisfaction, in some instances, is pain management. Ouch.

Even the Joint Commission, which accredits and certifies nearly 21,000 healthcare organizations in the U.S., has called pain a fifth vital sign. A well-meaning goal; an unwanted and unanticipated result.

Our healthcare infrastructure itself carries some responsibility for the epidemic. We allowed these powerful drugs into our healthcare system. Big Pharma did a great job of promoting the benefits of these drugs. We swallowed their message. Patients demanded the more powerful painkillers. The healthcare system responded, and in the process has created more than two million new opioid addicts since 2013.

I wonder how much research was done before this generation of opiates (think OxyContin) started showing up in our medicine cabinets. I wonder even more if we’ve learned our lesson from putting our front-line healthcare providers in the middle of this quagmire. I sincerely hope we talk about this issue—openly and candidly — to learn from this horrible chapter in American healthcare.

Statistics abound, but the societal costs are estimated to be over $55 billion since 2007. That’s quite a bit of pain.