Should Doctors be Held Accountable for Patients’ Opioid Addictions
There is an abundance of debate as to whether or not doctors should be held accountable for their patients’ opioid addictions. The National Institute on Drug Abuse (NIDA) states that there was a 2.8-fold increase in the total number of deaths involving opioid drugs from 2002 to 2015. Although, these incidents did not all occur randomly; many of these overdoses began with an opioid prescription medication that was originally prescribed by a doctor to relieve pain.
Take the opioid oxycontin for example; if an individual is prescribed oxycontin to relieve pain, and because of the drug’s addictive properties the patient becomes addicted to it, who is to blame? According to an article from NIDA, opioid drugs like oxycontin can be misused due to the euphoric feelings they produce as they relieve pain in the individual’s body. Oxycontin consumption must be carefully monitored to avoid abuse and overdose:
“OxyContin is the brand name for an opioid analgesic that is prescribed by doctors for chronic moderate to severe pain. It was approved by the Food and Drug Administration in late 1995. Because it has the ability to slowly release its active ingredient oxycodone over about a twelve-hour period, it is an effective and efficient medication for the millions of people who suffer from chronic pain each year. It is classified as a Schedule II drug, meaning it has a high potential for abuse and is only available by prescription by a licensed physician.”
There are many frequently asked questions in regards to oxycontin and its relation to opioids: is oxycontin an opioid/is oxycontin an opiate, what is oxycontin made from, and how addictive is oxycontin? Well, the term opioid encompasses all opiate drugs while opiates are drugs specifically derived from opium, so oxycontin is an opioid. Oxycontin is a semi-synthetic opioid that is made from thebaine, which is an opioid alkaloid found in the Persian poppy. Finally, oxycontin is so addictive that it is labeled as a Schedule II controlled drug. So, should a doctor be responsible for their patients’ addiction if they become addicted to oxycontin or other opioids since they are so addictive? The following news articles share some of the stories of individuals battling this situation.
Opioid Prescription in the News
One article from WJTV shares the story of a Mississippi woman, Beverly Dennis, who filed a lawsuit against her doctor, Dr. Michael Livingston, for causing her to form an opioid addiction. Livingston started prescribing phentermine, hydrocodone, and oxycodone to Dennis without checking through the Prescription Monitoring Service to see that she had already been prescribed hydrocodone in the same month by a different physician. Abby Robinson, Dennis’ lawyer, says that, “Livingston should have known that prescribing the two drugs along with oxycodone was dangerous. The lawsuit seeks compensatory and punitive damages.”
Another article from the National Public Radio (NPR) tells the story of a woman named Katie Herzog who experienced acute withdrawal after tapering off of Dilaudid (an opioid used to treat pain), which was prescribed to her after a nine-hour back surgery. She was instructed to take two pills every four hours as needed, and she did this for about two weeks. Herzog says that she wondered how long to stay on the drug, how to taper off of the drug, etc., but she never got any definitive answers from any medical professionals she asked. As she tapered off of Dilaudid on her own, she experienced withdrawal symptoms such as diarrhea, vomiting, muscle pains, and headaches. “I had every single symptom in the book, and there was no recognition by these really professional, senior, seasoned doctors at Boston’s finest hospitals that I was going through withdrawal,” said Herzog.
“Now, a handful of doctors and hospital administrators are asking, if an opioid addiction starts with a prescription after surgery or some other hospital-based care, should the hospital be penalized? As in: Is addiction a medical error along the lines of some hospital-acquired infections?” (NPR)
Michael J. Schlosser, chief medical officer for the Hospital Corporation of America, says that hospitals need to do more to protect their patients from opioid addiction. “Addressing long-term opioid use as a hospital-acquired condition will draw a clear line between appropriate and inappropriate use, and will empower hospitals to develop evidenced-based standards of care for managing post-operative pain adequately while also helping protect the patient from future harm,” said Schlosser.
An article from TIME also contributes to the idea that doctors should be held accountable for their patients’ addictions. The article says that the narrative is familiar, “a person gets a legal prescription for an opioid from their doctor after throwing out their back, then accidentally fall into a life of addiction.” A study published in the New England Journal of Medicine used data from individuals over the age of 65 who visited the emergency room. These people haven’t filled an opioid prescription in the last six months, and the emergency room doctors were ranked as high prescribers or low prescribers of opioids. The study showed that the outcome of a person’s life can be determined by which doctor they happen to see that day:
“Doctors in the top 25% of prescribers prescribed an opioid for nearly 1 in 4 of these emergency department patients, while in the bottom group, physicians prescribed patients opioids only 7% of the time. In other words, patients who saw a high prescriber were three times more likely to get an opioid prescription.”
Dr. Michael Barnett, health policy and management assistant professor at The Harvard T. H. Chan School of Public Health, was a part of this study and found that “for every 48 of these emergency department patients prescribed an opioid, one became a long-term user.” Although, this problem was not just happening with emergency room doctors, this epidemic was becoming prevalent in all regions of the medical profession. “I think it’s a warning shot to doctors about understanding the risks of these medications and communicating them much more clearly—both to each other during training, as well as the patients,” said Barnett.
Are Opioids Prescribed for the Right Reasons?
An article from CNN goes into detail about why doctors may not be overly cautious when prescribing opioid medications to patients. Insurance companies prefer the cost savings that comes along with prescribing these medications instead of a less-risky “multidisciplinary approach” to treating a patient’s pain. “For decades, certain pharmaceutical companies misled the FDA about the risks of opioid dependence in an effort to sell more of the drugs, and three top executives from Purdue Pharma even pleaded guilty to those criminal charges,” stated the article. Individuals should begin questioning the medications prescribed to them and exploring other options that could be used to relieve their pain, instead of consuming drugs that could potentially leave them addicted.
“It is an awful sight, and yet someone in this country dies like this every 19 minutes. There is no other medication routinely used for a nonfatal condition that kills patients so frequently. The majority of those deaths result from prescription opioid medications, such as hydrocodone, OxyContin and Percocet” (CNN).
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