By Constance Scharff, Ph.D.
It is no overstatement to suggest that prescription painkiller and heroin abuse is killing too many people we care for. According to the Centers for Disease Control and Prevention, 44 people die in the
By Constance Scharff, Ph.D.
It is no overstatement to suggest that prescription painkiller and heroin abuse is killing too many people we care for. According to the Centers for Disease Control and Prevention, 44 people die in the US each day from prescription painkiller overdose. Countless others become addicted. The death rate has been rapidly increasing since the turn of the century. Why? There has been a great deal of finger pointing. Some blame doctors for overprescribing. Overprescribing potent medications was part of the problem initially. Physicians don’t want to see their patients suffer. If pain is treatable, why not bring patients relief?
Unfortunately, the effort to treat every ache and pain coupled with a growing expectation among patients that every ache and pain should be treated, has gotten us into a quagmire that is literally causing tens of thousands of deaths each year. Are physicians responsible?
Not really. The truth is physicians in America don’t receive adequate training to recognize or treat addiction. It isn’t a condition most doctors want to deal with. Outside of drug seeking and illnesses associated with long-term substance abuse, most physicians will have only peripheral experience with addicts. Yet, there is a disconnect here, because while few physicians are trained to recognize addiction, let alone intervene, the public views doctors as experts in all things medical. When a physician prescribes a medication, the patient’s expectation is that the physician is aware of all the potential negative outcomes associated with that drug. Though unfair to both the doctor and patient, lack of education and incorrect public perception are part of the problem feeding this national epidemic.
To assist patients, physicians must do a better job of integrating addiction education into primary medicine. This means that doctors require an immediate upgrade in training in this area. There is good medical information on addiction available. Researchers’ understanding of addiction is growing. For example, researchers now recognize addiction not as the genetic disorder once imagined, but as a multifaceted neurobiological complex in which behavior changes the structure and function of the brain. Education and treatment must recognize this complexity and focus on intensive psychotherapy to get at the root causes of why the person abused substances in the first place; address co-occurring psychiatric disorders that complicate recovery; and offer a whole host of complementary therapies that serve to wire the brain in healthier ways.
In days past, physicians were often content to diagnose addiction, g