Fri, Aug 11, 2017 - Page 7 News List

Doctors at heart of US opioid crisis


Justin, a participant in a class on opioid overdose prevention held by non-profit Positive Health Project, practices with Naloxone on teacher Kieth Allen on Wednesday in New York City.

Photo: AFP

When 55-year-old Sheila Bartels left her doctor’s office in Oklahoma, she had a prescription for 510 painkillers. She died the same day of an overdose.

Her doctor, Regan Nichols, is now facing five second-degree murder charges — one for each patient who overdosed after she prescribed them opioid drugs, such as Oxycontin — prescriptions that can lead to addiction.

“Doctors bear enormous responsibility for the opioid crisis,” said David Clark, a professor of anesthesiology at Stanford University who worked on a government-sponsored panel that studied the crisis, and recommended new training and guidelines for healthcare providers and regulators.

“We didn’t have [a crisis] until doctors became enamored with what they imagined to be the potential for opioids in controlling chronic pain,” Clark said.

An estimated 2 million Americans are addicted to opioid drugs — many forced to buy pills illegally when prescriptions run out. Some, in desperation, resort to heroin and synthetic opioids smuggled into the US by Mexican drug cartels.

Ninety people die every day in the US from opioid overdoses. More than 180,000 have died since 1999, including pop icon Prince, who passed away in April last year at 57 after an accidental overdose of fentanyl, a powerful opioid painkiller.

Doctors in the US prescribe more opioids than in any other country — enough to medicate every US adult.

While those physicians who are prosecuted for overprescribing make headlines, experts say they are not solely to blame and that the US healthcare system as a whole must be held accountable for the nation’s spiralling opioid epidemic.

“Pharmaceutical companies targeted general practitioner doctors, the ones who see most of the people who have pain,” Ohio attorney general Mike DeWine said. “I think they certainly were misled, and they were told things that were not true.”

The problem is not a new one — it began two decades ago, as doctors were being taught to better manage their patients’ pain and drug companies were touting the efficacy of opioid painkillers.

The painkillers — meant for patients in the most dire need — started getting into the hands of those with chronic conditions that had been treated with over-the-counter drugs like aspirin. And they did not know they were addictive.

“You had people with a simple toothache, or knee surgery, or back surgery, that were on these opioids for too long a period of time or prescribed a higher dosage than they needed,” said Robert Ware, chief of police in the town of Portsmouth, Ohio, which became a sort of ground zero for the crisis.

As more people were getting addicted, “pill mills” began to pop up in Portsmouth and across the nation to meet demand. These clinics were run by doctors who would prescribe opioid drugs to anyone who could pay.

In Portsmouth, a struggling Ohio town bordering two other states where the steel industry was once king, Ware was seeing pill mills become part of the economy, as addicts from nearby states traveled there to get their fix.

Eventually, state regulators and local law enforcement shut down the pill mills by arresting doctors and requiring that clinics be associated with established, reputable medical programs.

The US Department of Justice has promised a further crackdown on unscrupulous doctors and pharmacists.

On Tuesday, US President Donald Trump suggested more prosecutions as a whole may be necessary.

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