How the Role of Doctors is Changing in the Wake of the Opioid Abuse Epidemic

Pushed and pulled by many competing interests, doctors are ultimately and unfortunately an important gateway to opioid-based prescriptions – and their abuse. Although providing medication to patients they see is a key part of their job, at this point an opioid-based prescription to relieve pain could cause suffering through its abuse or ease the physical suffering of chronic pain; knowing the outcome isn’t always certain.

Doctors will likely always be willing to provide prescription opioids to some of their patients, and that is appropriate, but as an epidemic of prescription opioid abuse rips across the country, physicians are being asked to adjust their roles as potential prescription providers in favor of a more holistic and informed approach to pain management. This too is an important change in function.

Treating patients holistically hasn’t always been physicians’ top priority. In the 1980s and ‘90s there was a surge of advertisements and information biased towards increased opioid use produced and distributed by some of the biggest pharmaceutical companies that manufacture opioid-based prescriptions. These misleading recommendations encouraged doctors to prioritize pain treatment through the use of prescription opioids and downplayed any risks of addiction or even potential abuse. In response, doctors began prescribing these potentially fatal drugs in record numbers. From 1999 to 2014, the total number of opioid prescriptions in the United States almost quadrupled; in 2014 doctors wrote 28,000 prescriptions for opioids.

After thirty years of prioritizing pain management and prescription use, doctors are beginning to use their crucial role as treatment providers to collectively shift away from primarily prescription-based treatment toward short-term prescriptions coupled with alternative methods to treat pain. Minimizing pain is no longer doctors’ first priority; ensuring a patient’s overall well-being is reemerging as the most important role for physicians.

Opioids will still be used for certain populations of patients. For those in hospice with only a short time left to live, opioid-based medications will remain available. Patients with grave diagnoses, like cancer, will also still be eligible to receive an opioid prescription at their doctors’ discretion. However, these instances are exceptions to a much broader new imperative to decrease the overall number of opioid prescriptions available to the public. It is still appropriate for some patients to have and use opioids. But many situations, such as tooth extraction, do not need to be medicated in this way for the long-term. Discerning who really needs opioids and where other pain medications or treatments might be a better choice is a doctor’s new priority.

There’s no doubt that ending the opioid epidemic will be a collaborative effort, but the role of physicians in providing long-term opioid based prescriptions to patients as their first tool to treat and manage pain must change. A better focus is on healthier alternatives to pain management, without the risks of abuse, addiction and overdose. Physicians must embrace their unique role in stopping the opioid epidemic in order for us all to overcome it.