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:
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.
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.
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.
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.
Check out this Informative Video by CNN:
To find out more Information about this Perspective:
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