The opioid crisis is one that touches nearly every Americans’ life. It’s becoming increasingly common to know someone who has or is currently struggling with opioid addiction. When grieving the loss of a loved one to opioid addiction, many people are quick to blame doctors because they prescribe opioids to patients. But is this an accurate accusation, or is there more to the story?
Opioids are drugs commonly used for pain management or other conditions such as a persistent or painful cough. Although opioids are naturally found in opium poppy plants, manufacturers can also make synthetic opioids by using the chemical structure from poppy plants. Opioids trigger the body to release large amounts of dopamine–your “feel good” hormones that improve your mood and make you feel happy.
One of the most common uses for opioids is pain management; for instance, after surgery or breaking a bone. A physician will prescribe an opioid to be used in the short term until acetaminophen can be used to manage pain; however, this is the beginning of opioid addiction for many patients. Since physicians are the ones prescribing opioids, aren’t they the ones to blame for the opioid crisis? Before jumping to conclusions, let’s examine the bigger picture.
The first culprit to examine is pharmaceutical marketing. Besides New Zealand, the United States is the only country in the world where pharmaceutical companies are allowed to market directly to consumers via advertisements on television, print, and smart devices. Pharmaceutical companies rake in profit as consumers are encouraged to ask their doctor about new drugs, including opioids. Many major pharmaceutical companies were caught in legislation in 2017 for using marketing schemes to persuade doctors and patients that opioids should be used for chronic pain while masking the addictiveness of opioids. But what the patient asks for is often what the patient gets from the doctor.
This leads to the next foundational piece of the opioid crisis: patient surveys. These satisfaction surveys, such as the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS), have been adopted by almost every hospital across the nation because the program financially rewards hospitals with high ratings. Hospitals receive more reimbursement from high ratings for relieving patients’ pain, even though studies show that patient satisfaction doesn’t correlate to quality care or outcomes. This financial incentive puts pressure on doctors to overprescribe opioids to receive better ratings, increase hospital revenue, and maintain salaries.
Instead of doctors acting in the patients’ best interest, hospital care has turned into doctors filling patient requests in order to improve satisfaction survey scores. The greedy demands of pharmaceutical companies and hospitals have not only reduced the quality of care but also stimulated an opioid epidemic.
It is understandable that many people blame doctors for the opioid crisis, but this is a false accusation. While there will always be doctors who are quick to prescribe pills to treat ailments, doctors shouldn’t ultimately be blamed for the opioid epidemic. While doctors write prescriptions, they are pressured and manipulated by pharmaceutical companies, insurance companies, and hospitals to use their doctorates for financial profit. In order to solve the opioid crisis, doctors must be free to practice medicine that is best for the patient without the pressure from outside influences.
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