Two recent news items about the prescription drug crisis in the U.S. offer larger insights when taken together.
The first item is a recent study released by the CDC, which found that prescription opioid “abuse” is down nationwide. This is good news, but it has to be taken with a grain of salt. Originally, the notion of “abuse” of prescription opioids was, pardon the pun, pushed by the pharmaceutical companies whose mass-marketed, mass-prescribed painkillers unexpectedly ended up addicting huge numbers of people who had never been addicted to anything else in their lives. “Abuse” was the dismissive term applied to ordinary pain sufferers to blame patients and absolve manufacturers for problems associated with widespread opioid prescribing for chronic pain.  So to say “abuse” is down sounds great, and it is great, but such a finding must be noted with qualification.

The CDC study also found that even though abuse is down, accidental overdose deaths are up nationwide. To the cynical eye, this means that when taken as directed, opioids for chronic pain can kill you. And today, this isn’t an entirely cynical view – it is the medical and scientific insight gaining steam in study after study. The data increasingly voices the concern that opioids for chronic pain could be typically addictive and ultimately ineffective.

BUT – have hope, because the second news item is the launch of a new education campaign which offers promise to both patients and doctors about the present situation.

The campaign is called “America Starts Talking,” and among its featured spokespersons is ex-NFL great Mike Alstott. He is the former pro running back whose bruising, consistent and reliable play season after season over his long career prompted TV announcers to quip “You’re in Good Hands With Alstott” whenever he had a carry. Alstott also got injured 47 times over his playing career and first took opioids (for acute pain) in college on the advice of team doctors and trainers. Fortunately, and unlike many other players, he never got addicted. Alstott is now working to educate patients on how to interact with their doctors and learn about the medicine in a full and responsible way, and to learn life-saving tips in the event a patient experiences a drug-related emergency.

Alstott’s participation in this effort resonates in important ways with the things I’ve always talked about in the Painkiller Law Blog. First, just as no running back will gain 40 yards or score each time he touches the ball, there is no panacea for chronic pain. Second, team media departments can promise all they want in pre-game ads, just like drug manufacturers can in commercials, but the real story is when the game is played, or the prescription written and the drug taken. Third, an initial game plan is essential, but if circumstances on the field change, adaptability becomes key, and responding creatively and wisely to a new situation is the only viable alternative. The original message from drug manufacturers that opioids for chronic pain are generally safe and effective is being disproven. Doctors and patients, pharmacists and police and Medical Boards and regulators, therefore must adapt. Education about whether to prescribe, not just how often and how much, is essential to practicing safe medicine and ensuring compliance with the law. Failing to change with the changing science is a formula for poor patient care, and will invite law enforcement scrutiny and possible criminal prosecution. Burying one’s head in the sand and hoping nothing bad will happen is foolhardy.  Steady, consistent training and play yield the same results as steady, consistent education, compliance and medical practice.  When it comes to safe, smart prescribing and safe, smart pain relief, be like Mike.

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