Like the average person, I have had routine dental work or medical procedures that brought about some moderate pain afterward. The common link with all of my medical procedures was with the doctors feeling compelled to prescribe narcotics for pain. Two specific incidents stand out. The first was when I was being discharged from a hospital after surgery and a nurse gave me extra non-scripted Tylenol with codeine. I was not in any pain nor did she ask me if I needed the medication. The medication was already listed as part of my discharge instructions to take if needed, therefore, I was initially confused as to why she felt the need to provide more. My confusion first went to appreciation thinking that this nurse was going the extra mile to help. Then it turned to frustration because she never bothered to ask or talk to me about my comfort level with taking a narcotic. The second incident occurred after another minor procedure. I specifically expressed to my doctor that I did not want to be prescribed narcotics, yet he still prescribed them insisting that I would need them due to the pain. I put my trust in this doctor and filled the prescription. I was ready to take the medicine as prescribed until I read the side effects involved with oxycontin. I elected to push through the pain I had using non-addiction-forming pain medication instead. I still recall the doctor being shocked when I returned for the after-visit check-up when they learned that I had not used the prescribed oxycontin.
My prior medical experiences with opioids led me to start watching the Hulu series, "Dopesick." The series is about the rise of the opioid crisis and the part that the Sackler Foundation and Big Pharma played. As mentioned, I am a person who has always tried to resist taking any kind of pain medication, yet it can be left out of your hands unless you are clear up front with your medical providers and hospital staff. For example, after recovery from surgery, people are routinely given morphine if they are able to tolerate it and do not have any adverse reactions. This fact is not necessarily spelled out to you unless you ask. The problem with some pain medications, particularly opioids, is the altered mental state of euphoria it can induce in some patients. It is this temporary high that can be dangerous to some individuals, particularly those with a high disposition for addictive behaviors or a family history of addiction.
"Dopesick" examines the opioid crisis using a small rural coal-mining town in Virginia as its backdrop. The problem with this story is that oxycontin only became a crisis when it plagued certain demographics and when those areas turned to other narcotics such as cheaper street drugs like heroin. Similar to what we saw with ignoring the crack epidemic until it infiltrated society outside of urban communities of color. We now have a pharmaceutical epidemic where there is too much money involved that takes precedence over the dangers of prescribing highly addictive medication. Today these pills are still prescribed with not nearly enough regulation. Doctors may now have to register any narcotics prescribed into a database working in concert with pharmacies, however, the potential for abuse and addiction is still dire. Oxy still appears to be administered by doctors indiscriminately without asking unsuspecting patients about their drug dependency backgrounds. We have essentially created a culture within society that makes it ok to take pain medications without examining or caring about the potential harm some may have. The medical professionals that are prescribing potentially addictive medications are not
even attempting to screen patients to determine their medical history or whether there is a safer, less potentially dangerous approach to their pain management.
We deserve better from our medical society. Prescreening adults and children for addictive history or behaviors is needed. In addition, exploring other options to pain management that are more focused on the patient’s needs as opposed to increasing profits for pharmaceutical companies should be done. How can a medication that can have such catastrophic results still be legally prescribed without the proper mental and physical pre-screening to account for people predisposed to addictive tendencies? We claim to have a process in place that looks at weighing the harm of a drug versus the benefits of its use. This is essentially supposed to be a risk factor management system. The system was established to examine the potential usefulness of a drug and determine whether its benefits outweigh any negative or adverse impact. In the case of oxycontin and its approval for use, the money was behind the corporation and allegedly that was the driving force behind its mass marketing and full authorization for use in pain management. Understanding these guidelines, it is up to us as patients to ask questions and push for alternatives. We need to commit ourselves to asking our trusted medical providers if they are in fact masking a problem of chronic pain instead of finding a long-term solution. In addition, if we are getting a surgical procedure or a non-invasive procedure we should be asking for a discussion on pain management upfront and hearing about all of the alternatives.
It is up to us to demand this commitment to engage in conversation with our medical providers before accepting any kind of narcotics to treat pain. If a pain scale exists and we are all different, there can not be one approach that fits all when it comes to pain management. There have been times when people have been prescribed medication without it being made clear what the risks are. There is also not enough discussion concerning whether the medication is needed before trying something less strong. In the case of pain medications and narcotics, this tactic is dangerous, outdated, and irresponsible. We live in a society that wants instant gratification without accountability. We deserve more and need to demand more attentiveness and recognition regarding the damaging potential impacts of overprescribing narcotics like opioids for pain. This should not just be a conversation in the suburbs or rural towns. This impacts all and unfortunately, as with other disparities, there seems to be a large impact on people of color but less of an outcry to change the narrative. Michael K. Williams, a talented performer, and activist who we recently lost to his own drug battle once said, “ No one wakes up one day and decides they want to become a drug dealer or they want to be a stick-up kid. Those decisions are made after a series of events have happened in one’s life.” In the case of large pharmaceutical companies and the medical community, they did decide to wake up one day and infuse a large amount of potentially dangerous medication into the unsuspecting medical community while impacting its patients all due to profit. They are essentially drug dealers hiding behind a corporation. Their profits will continue to grow while society’s opioid epidemic rages on. The questions are, what will we do to cease its hold on us and what will we do to change the trajectory so that we can save and improve the lives of our fellow members of society?