We are living at the end of an era. It is true that history is transparent; fluid, while we are living it, even for the most prescient people, and that it is difficult to understand the implications of our era looking to the future. It is more difficult to pinpoint...
Understanding and Fixing the Opioid Addiction
Opioid addiction and the increasing number of overdoses have finally caught the public’s attention. Some 107,000 people died of overdoses in 2021. About two-thirds of those deaths involved synthetic opioids like fentanyl, which is 50-100 times more potent than morphine. According to the Drug Enforcement Administration (DEA), in 2021, fentanyl killed more Americans than guns and traffic crashes combined.
How did this happen? Management of non-cancer pain went through a slow evolution starting in 1980. Then we had “pain as the 5th vital sign” — adding to the standard heart rate, respiratory rate, temperature, and blood pressure. We were told the new breed of opioids were “safe and effective” (just like the Covid vaccines).
Then physicians gave all the pain meds the patient said they needed based on some 1 to 10 smiley and frowny faces. Of course, we might have done a better job by just talking with the patient — seeing the patient as a whole. The patient may be someone who lost their job, whose dog just died, or who is miserable in their love life.
The next thing you know, patients got addicted, and we were told to cut back on the pain meds. Some states even had specific laws capping the number of pain meds a patient could legally obtain. Then patients got drugs on the street. The drugs were laced with the faster-acting and more powerful fentanyl, a narcotic legitimately used as an anesthetic in hospital settings. Fentanyl was cheap (like other things from China) and flowed freely across the Mexican border. Then the patients (and other opioid users) started to die from overdoses. What comes next?
Dr. Molly Rutherford is the founder, medical director, and physician at Bluegrass Family Wellness — a direct primary care clinic in Kentucky. She is board certified in Family Medicine and Addiction Medicine, and employs a holistic approach to her patients’ physical health. She has more than a decade of experience treating opioid addiction.
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