Prescription Opioid Epidemic and Feeding Issues

Since the issue of the prescribed opioid epidemic is becoming increasingly more difficult to control in the United States, the introduction of legal repercussions, i.e., fines and imprisonment for doctors, pharmacists, and pharmaceutical executives that encourage the opioid epidemic by prescribing strong opioids in large doses, must be viewed as the solution that will ultimately lead to improvements (Manchikanti et al. S58; Kennedy-Hendricks et al. 65; Rutkow et al., “Most Primary Care Physicians” 488; Rutkow et al., “Effect of Florida’s Prescription Drug” 1647; Powell and Pacula 42; Popovici et al. 297).

Problem Description

When considering the key factors that have contributed to the aggravation of opioid dependence among patients with severe pain and the following breakout of the opioid epidemics, one must mention the propensity among physician to prescribe the doses of opioid drugs that can be deemed as excessive (Manchikanti et al. S57). Indeed, reports show that, in a number of cases, physicians prefer to prescribe a high dose instead of considering the unique characteristics of their patients, such as their weight, height, resistance to opioid drugs, and the severity of the pain that they experience (Powell and Pacula 44). As a result, the process of developing a chemical dependence on opioids becomes vast and, in most cases, irreversible (Kennedy-Hendricks et al. 64).

Furthermore, in a range of instances, physicians tend to prescribe the opioids that have an immediate and very powerful effect instead of suggesting the medications that have a lesser effect (Rutkow et al., “Effect of Florida’s Prescription Drug” 1647). While the identified choice is rather easy to understand since physicians are guided by the need to relieve their patients of pain, the specified approach can be substituted by alternative strategies (Rutkow et al., “Effect of Florida’s Prescription Drug” 1648). For example, healthcare practitioners addressing severe pain in their patients may consider using therapies aimed at assisting the target demographics in controlling their pain levels (Powell and Pacula 42). Nevertheless, most physicians show the propensity toward choosing the easiest and, unfortunately, the most harmful way of relieving their patients of pain. As a result, immediate addiction to opioid drugs is developed (Powell and Pacula 44).

The problem is aggravated extensively by the fact that people that have developed an opioid dependence are typically ostracized by the society because of the stigma of drug addicts (Manchikanti et al. S60). Due to numerous prejudices against people with a chemical dependence, the support system of the people that have been affected by the opioid epidemics is very weak (Rutkow et al., “Effect of Florida’s Prescription Drug” 1651). Consequently, patients that have developed the specified problem as a result of unprofessional prescriptions made by their healthcare practitioners may not even have the opportunity to present their case and receive the assistance that they need to handle the problem.

Factors Affecting the Problem

It is remarkable that even most physicians claim that healthcare practitioners are partially, if not fully, responsible for the development of opioid dependence in patients (Popovici et al. 299). Nevertheless, key providers of the relevant services and medications continue to offer the same type and amount of medicine despite the need to reconsider the framework for managing the specified process.

The lack of legal repercussions for the healthcare practitioners that disregard the methods of identifying an appropriate dose of opioids has a drastic effects on patients’ well-being (Popovici et al. 298). With the absence of any negative personal outcomes of their careless decision-making, as well as the lack of focus on the personal needs of patients, healthcare practitioners, pharmacists, and the related stakeholders fail to deliver the services that the target population requires and, instead, succumb to the traditional methods of handling health concerns among patients with severe pain.

Finally, the lack of tools for reinforcing new instructions that require more careful measurements and a more detailed analysis of patients’ medical history, personal characteristics, and other aspects of their health status that will ultimately allow for an accurate identification of a proper medicine and its dose, needs to be listed among the essential factors (Voelker E2). Therefore, appropriate tools for changing the current situation must be introduced. The alteration of the existing legal standards for addressing the inaccurate prescription of opioids must be deemed as the most efficient way of handling the crisis. It should be noted that similar strategies have been adopted in some states, West Virginia being one of them.

West Virginia

The situation can be described as especially complicated for the residents of West Virginia. According to the official statistics, the state has been affected by the opioid epidemics much more than the rest of the areas (Voelker E1). According to the recent news provided by JAMA, the number of patients suffering from prescribed drug overdose has been on the rise since the mid-2000s and still takes place in West Virginia (Voelker E1). For example, the article points to the unsuccessful attempts of local authorities to introduce legal changes that were expected to lead to drop in the number of opioid dependency instances: “A lawsuit filed last year charged that 9 distributors, including CVS Indiana and Walgreen Eastern Co Inc., failed to investigate and stop 40 million prescription hydrocodone and oxycodone pills from flooding the county between 2007 and 2012” (Voelker E1). It is worth noting that, while having a sensible idea of introducing regulations at its core, the reform failed since it did not embrace every single stakeholder or factor that contributed to the aggravation of the issue.

Although the steps that have been taken so far in West Virginia regarding the problem of prescribed opioids and the opioid epidemics have not led to tangible outcomes yet, one must admit that the change toward the management of the issue has been steered in the right direction. The opioid epidemics must be recognized as a legitimate threat to people’s well-being on a legislation level. Particularly, regulations must be used as the primary tool for controlling the problem. However, the focus of the changes that have been made by the West Virginia government could use a significant improvement since opioid medication distributors are not the only party that is responsible for the development of the opioid crisis. Apart from the companies that produce opioids, healthcare practitioners who refuse to accept new standards for opioids prescription must be viewed as the factor that contributes to the continuation of the crisis (Fudin).

Solutions

Studies show that the introduction of criminal responsibility for failing to follow the suggested standards for opioid drug prescription is likely to affect the levels of the epidemic to a considerable degree (Voelker E1). For example, Ault asserts that, when facing the threat of a criminal record, pharmacists become unwilling to succumb to the traditional, careless attitude toward selling customers prescribed opioids (Popovici et al. 297). According to a recent analysis of the subject matter, “The Board of Pharmacy in states such as California have been increasing the number of investigations against pharmacies, pharmacists, pharmacy technicians, intern pharmacists, and associate staff members for not carrying out corresponding responsibility’ or addressing ‘red flags’” (Fudin). Therefore, measures for introducing a coherent approach toward prescribing and selling opioid drugs to patients must be introduced on a legal level so that the task of monitoring the process and identifying the instances that do not align with the suggested strategies could become easier.

In addition, because of the increase in the instances of nonmedical use of opioids, the introduction of legal repercussions for the inappropriate prescription of opioids must be regarded as a crucial step toward addressing the opioid crisis (Popovici et al. 297). The specified change will allow for a significant drop in the number of instances in which healthcare practitioners provide patients an opportunity for the nonmedical use of opioids.

Refutation

It could be argued that the identified situation regarding the lack of integrity among healthcare practitioners in prescribing opioids, particularly, the practice that involves offering opioid drugs to people for nonmedical purposes, is linked to the problem of values and ethics in healthcare rather than the lack of an appropriate legal framework. The introduction of legal regulations and punishments for the healthcare practitioners that prescribe opioids for nonmedical use may be seen as a temporary solution to the situation, yet it will require a drastic change in the set of values by which healthcare providers are guided when making a prescription. Put differently, it is necessary to encourage proper behavior by focusing on rehabilitation rather than punishment.

However, the specified approach does not guarantee that healthcare practitioners will accept new sets of values and philosophies immediately. Quite the contrary, a significant amount of time will be required to instill the specified values and philosophies, whereas a radical change in the framework for managing the prescription of opioids is a matter of high urgency. Therefore, a set of legal instructions that will imply imposing big fines and even sentencing pharmacologists, healthcare practitioners, and other parties contributing to the enhancement of the opioid crisis must be viewed as the measure of reducing the levels of crisis and, thus, helping address the needs of the vulnerable population.

The use of fines and the threat of an arrest will serve as the restraining factor for the agents that feed into opioid addicts’ dependence and, thus, lead to the increase in the levels of the opioid epidemics. Studies point to the fact that healthcare practitioners, pharmacists, and other parties that are either fully or partially responsible for the prescription of the drugs that lead to the development of chemical dependency respond to rigid legal repercussions. For instance, the regulation that was introduced into the Florida legal environment and implied fines and even jail time for healthcare practitioners that are a part of the pill mill business have led to significant improvements in the levels of the opioid dependence among patients (Rutkow et al., “Most Primary Care Physicians” 489). Thus, the problem of the opioid crisis needs to be addressed from the legal perspective first. Prior to introducing ethical standards that will help shape the attitudes of responsible parties, one will have to close the existing legal loopholes that create premises for fraud. As a result, the platform for changing the philosophies and ethical standards based on which decision-making occurs in the specified environment will be created.

Works Cited

Fudin, Jeffrey. “Don’t Ignore These Opioid Abuse Red Flags.” Pharmacy Times, 2017. Web.

Kennedy-Hendricks, Alene, et al. “Primary Care Physicians’ Perspectives on the Prescription Opioid Epidemic.” Drug & Alcohol Dependence, vol. 165, no. 1, 2016, pp. 61-70.

Manchikanti, Laxmaiah, et al. “Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines.” Pain Physician, vol. 20, no. 2S, 2017, pp. S3-S92.

Popovici, Ioana, et al. “The Effect of State Laws Designed to Prevent Nonmedical Prescription Opioid Use on Overdose Deaths and Treatment.” Health Economics, vol. 27, no. 2, 2018, pp. 294-305.

Powell, David, and Rosalie Liccardo Pacula. “Prescription Opiates and Opioid Abuse: Regulatory Efforts to Limit Diversion from Medical Markets to Black Markets in the United States.” Dual Markets, vol. 1, no. 1, 2017, pp. 37-54.

Rutkow, Lainie, et al. “Effect of Florida’s Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use.” JAMA Internal Medicine, vol. 175, no. 10, 2015, pp. 1642-1649.

“Most Primary Care Physicians Are Aware of Prescription Drug Monitoring Programs, But Many Find the Data Difficult to Access.” Health Affairs, vol. 34, no. 3, 2015, pp. 484-492.

Voelker, Rebecca. “A Day in the Life: Facing the Opioid Epidemic in Huntington, West Virginia.” JAMA, vol. 1, no. 1, 2018, pp. E1-E2.