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Breaking down opioid myths

Marty Olsen, Community Voices Columnist • Jan 16, 2019 at 8:15 AM

More than 42,000 Americans died from opioid overdoses in 2016. Opioid overdose deaths have now surpassed automobile accidents as a cause of death for U.S. citizens. Civic and healthcare leaders around the country are constructing plans to deal with the ever expanding opioid epidemic, but they struggle with much misinformation on the topic. Here are five myths about the opioid epidemic that obstruct policy efforts to combat this crisis.

Once people are addicted, there is nothing you can do about it. They’ll always be addicts.

Patients tell me they’ve heard this myth from some doctors who decline to lower their suboxone doses when the patient wants to start coming off Medical Assisted Therapy on this medication. “You’re an addict, if I taper your dose lower you might relapse,” the patients state they are told. But in our country there are some “special” patients who do have the chance to come off suboxone. Are pilots allowed to fly while taking suboxone? No, so opioid addicted pilots have the chance to stop suboxone, even thought they too would be at risk of relapse. In my opinion, if one group of patients is treated differently than another group of patients, there should be a scientific reason why the different treatment plan is indicated. Many of my pregnant addicted patients are thrilled with the chance to work with a doctor and drop their medication dosages. No, they don’t all have success but they deserve the chance to give cutting the dosages a try as long as they understand the risks of relapse.

Narcotics prescribed by doctors are safe. It’s those illegal drugs like heroin that are the real problem. 

It turns out that over 40 percent of overdose deaths are because of prescription drugs. And we mustn’t forget the concept of a gateway drug. That’s the drug that addicts first become addicted to. It turns out that in the U.S., 75 percent of heroin addicts started out on prescription drugs. Obviously, prescription medications are the major fuel for the growing opioid epidemic in our country.

Drug withdrawal in newborn infants is an expected and easily treatable condition.

This widely believed myth is cited by some doctors as a reason to keep pregnant women on the same dose of MAT during pregnancy that they were on before conception. Like many medical conditions, there is a death rate associated with drug withdrawal in newborns (it is about 1 percent) and the cost is tens of thousands of dollars per baby. But also very concerning are the long term effects — babies who survive drug withdrawal (also called Neonatal Abstinence syndrome or NAS) are more likely to have school performance problems in elementary school. Obviously, if a child has trouble learning in the first grade, then that child and its community have a problem that may last 70 or 80 years.

Prescribing more suboxone decreases overdose rates.

Suboxone is the most commonly prescribed drug used in MAT. MAT allows patients to control the symptoms of drug withdrawal. Let’s make sure it is clear that MAT with medications such as suboxone is lifesaving for some individual patients. People who wake up every morning wondering where they are going to get their next fix can get control of their lives, work at their jobs, contribute to their communities and once again be a joy to their families. But the data in the state I live in — Tennessee — is clear. Buprenorphine (the ingredient in suboxone) prescriptions nearly doubled in Tennessee between 2011 and 2016. During the same time interval, opioid overdose deaths increased by nearly two-thirds. Increasing the number of suboxone prescriptions did not lower the death rate. Passing out more and more suboxone is therefor not the answer to decreasing the numbers of patients afflicted by the opioid epidemic. We need to look hard at how this medication is administered in order to ensure that it is doing maximal benefit for afflicted communities. 

If no one in my family is affected by the opioid epidemic then I don’t need to worry about it.

The opioid epidemic has negative economic impacts in the regions most severely afflicted. Existing businesses have trouble hiring enough employees that can pass drug screens and businesses from outside these regions are reluctant to move to areas where they may be unable to recruit sufficient numbers of drug-free employees. This lack of business growth hurts everyone in an afflicted region. In many areas of our country, most families can identify at least one member who suffers from addiction. But even citizens who are fortunate to have unaffected families still will be affected by the economic costs created by the diminished potential of their fellow citizens who happen to suffer from the medical condition of drug addiction.

The opioid epidemic is a problem that all citizens need to consider when selecting their leaders.

Dr. Marty Olsen is an obstetrics and gynecology physician in Johnson City. He has interests in international medicine and in confronting the opioid epidemic

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