An MD Who Understands the Opioid Epidemic

Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place? According to Dr. Sanjay Gupta, senior medical correspondent at CNN, the very doctors who prescribe opioids deserve a lion's share of the blame – and a lion's share of the responsibility to help rectify the situation.

In "Prescription Addiction: Doctors Must Lead Us Out of Our Opioid Abuse Epidemic," an illuminating feature article with accompanying video published on CNN.com, Dr. Gupta outlines the crisis in shockingly candid fashion (particularly for a medical doctor). Here are just some of the sound bites from the article:

• "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."
• "As of 2011, 75% of the world's opioid prescription drugs are prescribed and swallowed up in a country that makes up less than 5% of the world's population, leading to the most common cause of preventable death in America today. It is a horrifying and shameful statistic."
• "Most of the blame ... belongs on the shoulders of the American doctors themselves. ...The fact is, we have accepted the tall tales and Pollyannaish promises of what these medications could do for too long. As a community, we weren't skeptical enough. We didn't ask enough questions."
• "Even worse, too many doctors who didn't actually believe the hyperbole surrounding opioids doled out long-term prescriptions regardless, in the same way doctors write antibiotic prescriptions for viral illnesses. In both cases, they don't work."
• "Most disturbing, however, is a recent study showing that 91% of people who survived an overdose were still able to get another opioid prescription, typically from the same prescribing doctor."

While Dr. Gupta doesn't mention chiropractic care as an alternative option, he clearly illuminates a path out of what he calls "a completely man-made" public-health epidemic – and puts the responsibility squarely on the shoulders of all doctors who prescribe opioids – that relies on the concepts chiropractors hold dear: patient-centered care, alternatives to medication, and pain strategies that do good, not harm:

"[M]ost simply, we as doctors need to engage our patients and discuss treatment with them, whether its short term opioids or alternatives like physical and occupational therapy. We need to help set realistic expectations for our patients: Living entirely pain free is not always possible. As doctors, we need to have follow-up conversations with our patients to see how treatment is going. If we better understand our patients, we can provide better treatment and help develop pain strategies that are effective and safe."

To read Dr. Gupta's May 11, 2016 article in its entirety and view the accompanying video, which includes highlights from a town-hall discussion on the opioid epidemic featuring Dr. Gupta and CNN news anchor Anderson Cooper, click here.