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The Opioid Epidemic

Are doctors responsible for the harm that opioid prescription drugs pose to patients?

First off: What is the Opioid Epidemic?

Over the last few years, the phrases “opioid epidemic” or “opioid crisis” have become increasingly popular considering how many individuals rely on opioids for pain management. It is estimated that one in three Americans are prescribed an opioid and 40% of those people will become addicted. Since 2000, it has claimed more than 300,000 lives in the US and some say that the healthcare system is to blame.


Sustainable Developmental Goals:

Goal #3: Ensure healthy lives and promote well-being for all at all ages

Goal #10: Reduce inequality within and among countries

Check out this Sample Case Study:

The patient in the hospital complains of severe pain and demands painkillers. The doctor prescribes opioids, but it was discovered that she was selling her pain medication on the street.

Ethical questions to consider:

Should the team again prescribe this patient opiate pain medication on discharge to treat her pain until outpatient care could be established or should treatment be withheld due to the knowledge of the patient’s continued illicit drug use and the selling of her prescription medications?”

Things to consider:

Her pain level: we don’t know if she is truly in pain and withdrawing pain medication could harm her

Potential harm to the buyers: by continuing to give her pain meds, putting her buyers at potential harm to become addicted

Principles of Bioethics in this case:

Nonmaleficence: giving her prescription opioids for her pain just for them to be sold on the street has repercussions beyond herself. can end up supporting her and the people that she’s selling to’s drug habit. It needs to be balanced with physician’s providing prescription drugs to those that actually need the drugs.

Autonomy: Physicians have to respect patient autonomy while trying to help them. Physicians cannot endorse decisions that will harm the patient’s health like the patient who was abusing meth and demanding pain meds for her pain while selling them on the street.

Beneficence:  Refuse to give opioids to her and provide other strategies to help her. This will benefit her health and the health of those that she was selling too in the future.

Principles of Bioethics:

Nonmaleficence:

Doctors trying to treat a patient quickly vs. effectively are harming patients in the long run because by not thinking of different treatments that have lower risks and the same effect, doctors are increasing the chances of the patient becoming addicted to the opioid when there could have been an alternative solution less addictive. There is potential harm in doctors prescribing opioids as the “go-to” pain medication to treat pain instead of looking for alternative, less addictive medication.

Justice

Underprivileged people that do not have access to alternative sources of treatment besides opioids are more prone to becoming addicted because their doctors don’t have as many options for treatment within a patient’s budget. Access to equal healthcare is not present because not all people can access non-opioid treatments based on money. Also, certain societal stereotypes are unintentionally practiced when prescribing pain medication leading to unequal care from healthcare providers.

Autonomy

Patients have very little say on whether or not they want to be treated with an opioid or something else if they are financially bound to receiving opioid treatments that are usually cheaper. They are being coerced into purchasing opioids and it is not always in their best interest and can lead them to become addicted.

Beneficence

Actions by the doctor are meant to benefit the patient, therefore when a doctor doesn’t take the time to weigh the treatments and risks of different treatments, and simply prescribing opioids to combat the pain, they are not acting in the patient’s best interest, but instead making the problem worse in the long run. Doctors that take the time to go over different treatment options and the benefits and risks of each, including opioids are following the principle of beneficence and helping the patient.

How does Stigma Play a Role?

A drug user is a “bad” person, typically African American, Hispanic, or poor who only cares about drugs and nothing else. This is the stereotype that many people around the United States have been conditioned to think. This stereotype is sometimes practiced by doctors, leading to a poorer quality of care for these people.

Doctors unintentionally conform to this stereotype causing harm to certain patients. It has been reported that African American patients receive lower-quality pain treatment and biases from different doctors. Years ago, the opioid crisis was considered “a black problem” and very few cared. More people have realized that it isn’t “a black problem” and are beginning to care more.

The stereotypes that we hold now lead to the discrimination and the mislabeling of certain ethnicity being the “drug addict” race.

Check out this Informative Video by CNN:

To find out more Information about this Perspective:

https://www.wsls.com/opioids-epidemic/what-role-have-doctors-played-in-creating-the-opioid-crisis

Why is this SO Important?

In order to understand the different perspectives the opioid epidemic has, we need to learn more about the responsibilities that doctors have as medical professionals and how their actions regarding pain treatment have negative consequences on their patients.

Doctors have a responsibility to provide equal healthcare and treat patients as best as they can. That doesn’t mean that they can keep prescribing prescription drugs to “treat” pain for all patients. Based on this project, I’ve learned that prescription drug addiction is a complicated and sensitive topic with different perspectives from the doctor, the patient, pharmaceutical companies and society. As a doctor, they have a responsibility to responsibly prescribe prescription drugs depending on the patient’s symptoms.

Call to Action

  • STOP associating minority races with substance abuse and addiction. These stereotypes unintentionally affect the way doctors and others see other people and affect their quality of care when it comes to pain management and medication.
  • Improve medical education for health care professionals in order for them to be more knowledgable about different pain medication and management and the risks of addiction. This will improve the quality of care that health care providers are providing for patients because they will be more knowledgable about pain management and medication.
  • Policy changes for pharmaceutical companies that will make it more difficult for patients to obtain prescription drugs if unnecessary. If it is easy for patients to obtain prescription drugs, more people will have access to prescription drugs and be at a higher rate for addiction and overdose.

Author: Alison Lu

Works cited:

https://docs.google.com/document/d/1omtQMvz-u3f4tjRXyFsc3A-SrYxr0RhXp8oPxdEAhCI/edit?usp=sharing


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COMMENTS: 12
  1. April 26, 2019 by Katherine.Holder

    Very impressive presentation – was wondering how you chose this topic? Recently lost 2 people in my sphere to opioid overdoses and I enjoyed your call to action at the end.

  2. April 27, 2019 by Luciano Ferrato

    Hey Alison,
    Your presentation I want to say is really well put together. Color coding, information transitions, substance and format. As someone who lives in Ohio, Opioids are a frequent conversation within my community. How can we specifically alleviate stigma around minority races? I personally found working at a homeless shelter and talking to the people in the Gateway community and Independence community helps alleviate stigma through humanizing or associating the idea of something with a person. Anyway great presentation and for anyone that is interested in volunteering and are in Ohio visit: https://www.lutheranmetro.org/volunteer/

  3. April 27, 2019 by Alison.Lu

    Hi Katherine,

    Thank you, I think that my interest in pharmacology is what sparked my interest in this subject so I decided to do this project!

  4. April 28, 2019 by Annabel.Sumardi

    Alison,
    Your topic is actually similar to mine as I decided to focus on substance abuse in my presentation. I really like how you included the principles of bioethics and connected them to your topic! It makes your presentation look a lot more professional and the paired visuals look great! What are some policy changes which you might suggest to a pharmaceutical companies to help end the problem?

  5. April 28, 2019 by Jalen.Rucker

    Great Job!

  6. April 29, 2019 by Alison.Lu

    Hi Annabel,
    I think that things that pharmaceutical companies can do would be to try R & D with less addictive drugs, but also pharmacists and doctors need to have stricter protocols about prescribing drugs so that it isn’t easy for those that don’t need it to receive it.

  7. April 29, 2019 by Anjali.Mirmira

    Hi Alison,
    Awesome presentation! I think it’s so interesting how you talked about the opioid problem being associated with a “black problem” in the past, and how no one cared. As someone very interested in the intersection between disease and sociology, this really had me wondering, are there any therapeutic approaches to address this crisis on the social level? In other words, are there ways and methods to target the inequality behind this epidemic and offer treatment?

  8. April 29, 2019 by Gianni.Notaro

    Hi Alison,

    I enjoyed your project because of the visual format. It made it really easy for me to track what you were saying. I’m glad you chose to present on the opioid epidemic.

  9. April 29, 2019 by Sophia Nappo

    Hi Alison,

    Amazing job! I love how you provided a new and different lens towards analyzing and understanding the opioid crisis. Having taken bioethics before, I love how you utilized the key components of analyzing this issue with the viewpoint of a bioethicist. I wonder how you feel we can get rid of the stigma around minority races?

  10. April 29, 2019 by Alex.Lepa

    Hi Alison,
    I really enjoyed your presentation. I especially liked the principles of bioethics which helped me better understand the crisis. Thanks again.

  11. April 29, 2019 by Aminah.Asghar

    Hey,
    I loved your presentation, the infographics were super engaging! I also enjoyed the call to action, so glad that you highlighted harmful stereotypes in your project.

  12. May 01, 2019 by Alison.Lu

    Hi Sophia,

    I think that something that is important to note is that America has had a lot of history with racial discrimination and it’s something that not a lot of people see, but is still present. Something that we can do to prevent this would be to not let people share their own discriminatory stories and let it affect us because sometimes we hear stories about some person and identify them by their race. Thanks for being aware of this!

    Alison

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