Opinion: The 'Opioid Crisis' Needs More Than a Public Health Emergency Declaration

Ilene Corina

By Ilene Corina, President, Pulse Center for Patient Safety Education & Advocacy

President Trump's announcement on Oct. 26 that opioid addiction and overdoses constitute a public health emergency in the U.S. acknowledged a situation that the media has covered widely in the past couple of years. As such, it is to be welcomed.

The directive is limited in its practical consequences and does not add any federal funding to programs aimed at addressing the crisis. But more importantly, it is reactive rather than proactive: it does not address one of the root causes of the problem.

Of course one could identify several "root causes" — a widespread sense of social disenfranchisement, the structure of the American healthcare system, the behavior of the global pharmaceutical industry, and the apparent willingness of some doctors to prescribe large quantities of very addictive substances without due caution. These are huge issues, unlikely to be solved adequately by federal programs.

But what can make an immediate difference is the consumer — the patient. What's new in today's crisis is that many of these drugs didn't originate on the street: they were prescribed by doctors to non-criminals for legitimate pain relief. Anyone who even sprains an ankle or breaks a bone is at risk of becoming addicted or dependent on drugs. But how many of those patients really understood the addictive potential of these painkillers? On the evidence, not enough.

For years, we at Pulse Center for Patient Safety have been saying that solving the opioid drug abuse problem needs to start with education about safe medication use before the prescription is written. Just last year, Pulse held a symposium on the topic "Medication Safety: It Starts Before the Prescription." The issue of painkiller use (sometimes leading to heroin addiction) — unlike that of medication errors within hospitals — is one that people in their own communities, educated and made aware by organizations like Pulse, can and must do something about.

Coupled with education is a concept we call the "Designated Medication Manager." Similar to a "designated driver," a DMM is someone responsible who agrees to help manage your medications. It can be a family member, friend, clinician or patient safety advocate. Among other things, the DMM can go to the doctor or pharmacist with you and make sure you understand the instructions for their medications, and offer to research any medication side effects or adverse events that may occur.

Governments providing addiction rehab services or trying to educate medical professionals about responsible prescribing may help in the short-term, but they are like "fighting the last war, not the next one." Educating and preparing the public will help solve this problem in the long term — but to do that, we need more awareness and better funding for such grassroots community efforts.

To discuss this topic further, please contact Ilene Corina: (516) 579-4711 or icorina@pulsecenterforpatientsafety.org.

Source: Pulse Center for Patient Safety Education & Advocacy