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By Anika Gupta
Purdue Pharma has been ordered to pay $7.4 billion for its part in the opioid epidemic.
The company has been criticized for its aggressive and deceptive marketing of OxyContin, an opioid painkiller, because it downplayed the potential dangers of addiction. Purdue Pharma is just one example of a broader pattern of pharmaceutical companies driving overprescription practices that have affected patient care.
The healthcare response to this is seen through professionals like Aditi Gupta who works at the University of Kansas Medical Center as a professor of internal medicine and neurology and director of clinical trials in the division of nephrology, the field focused on diagnosing and treating disorders in the kidney.
Her profession allows her to prescribe opioids, mainly for post-surgical pain. She states that when she first started working, “everyone stressed pain control, that you should have perfect pain control; there were all good intentions of following the [pain medication] guidelines, but those guidelines were based on false evidence.”
The emphasis on eliminating pain, combined with misleading information from pharmaceutical companies contributed to widespread overprescribing. This issue escalates when the risk of addiction is introduced. A Center for Disease Control and Prevention (CDC) study stated that a one-day opioid prescription carries a 6% chance the receiver will still be using the opioid at one year but if a healthcare professional increases it to an eight-day prescription, the risk goes to 8.5%, and a month-long prescription goes to a 30% risk.
In the pursuit of lessening pain, addiction risks have increased significantly.
As the opioid epidemic rose, so did the healthcare response to addiction. Doctors shifted toward a more cautious approach that considered the patient’s potential for adverse results.
When asked how a health professional can spot addiction or opioid misuse, Gupta explained that “understanding what’s happening, when the pain increases, what makes the pain worse” is essential for gaining insight on how the patient is responding to their medication.
She added that “inconsistencies in their story” or repeatedly losing medication are on her warning signs list.
For patients to get the help they need, they may be sent to a pain management specialist, Gupta said. Doctors and healthcare professionals have had to adapt their practices to watch for the signs that had been commonly missed in the past.
Rather than focusing on pain, doctors also have to watch out for future consequences like dependency or misuse. Though opioids are still commonly prescribed the 44.4% decrease in opioid prescriptions across the nation has aided doctors in their efforts to mitigate addiction.
What began as an effort to manage pain soon lost control as pharmaceutical companies took advantage of the healthcare system and guidelines failed to catch up fast enough. Healthcare workers have since become more vigilant in identifying problems that they may have been blind to before.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
