More Americans died of drug overdoses in 2016 than died in the entirety of the Vietnam War.
Sixty Minutes did a program on Sunday evening (9/30) about how law enforcement was closing pain centers in Florida and Tennessee who were subsidizing the distribution of pain killers and perpetuating the opioid crisis. They even went so far as to blame the crisis on physicians. Starring in this episode was Barry Schultz who made more than $6,000 a day pushing opioids in his clinic. He currently is convicted and in prison for 157 years. This is the largest sentence ever given to a physician. Florida was reported to have become a haven for pain clinics with more than 31 clinics located on the same street. Users were migrating to Florida to get their prescriptions where they were filled on the premises. Schultz was accused of prescribing 1,000 oxycodone to a pregnant patient in one month and another patient received 60 pills per day. It was reported another patient received 22,000 pills in one year. The crowds at these clinics had lines out into the streets. This occurred because Florida did not have the any laws to enforce to prevent this from happening. The legislature has since corrected the problems and the clinics and the physicians have been closed and many sent to prison.
But what about the aftermath for addicted patients? Who is going to help the many who are addicted or are really suffering from intractable pain?
An article from the NY Times by Jan Hoffman dated September 10, 2018, shares the gloomy truth that most providers are ill-equipped to help Americans survive the Opioid Crisis. Although the United States House of Representatives authorized a bill in June 2018 to reimburse education costs for providers working in fields affected by addiction, the ability to obtain adequate addiction training leaves providers in a bind. Most providers receive little or no training in addiction disorders or treatment. According to the CDC, addiction kills 632,000 people in the U.S. annually.
There are only 52 addiction medicine fellowship programs in the U.S. as compared to 235 for sports medicine. Only 15 out of 180 medical schools in the U.S. teaching addiction as an inclusion to the training on alcohol and tobacco. In medical schools where there is addiction medicine training, such as Boston University, there is serious concern from professors about the sustainability of the training. The availability of trained fellows to oversee medical students leaves a huge gap that can’t be filled at present.
The future is not looking much brighter, because there are very little incentives encouraging physicians to pursue addiction specialties. Reimbursement for addiction treatment is either too low or not recognized outside of mental health therapy. There is a stigma associated with addiction therapy that it is a waste of time, and that most patients are incurable.
Despite the stigma, some physicians are determined to pioneer the field for the future of medicine. Dr. Bradley M. Buchhiet from Boston Medical Center eagerly treats patients with opioid addictions and trains other providers to build relationships with their patients that will enable better outcomes. Provider training skills encompass chronic pain management, substance use and communication.
There must be recognition by our society that this problem must be met. It must be met with trained professionals who can apply the correct methods for help and support. It is an issue that reaches across the generational gap.
President/CEO: Marilyn Sackett, M.Ed, RT (R)