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The Washington Post

Opinion Editorial: Combatting the Opioid Epidemic. How can prescribers affect change?

In 2015, approximately 2 million people had a substance use disorder due to using prescription pain relievers and over half a million-people had a heroin addiction. During the first half of 2016, nearly 60,000 individuals died from overdose related deaths and this number is expected to rise. Opioids are a class of drugs that include heroin, prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl and many others. Opioids chemically interact with opioid receptors on nerve cells in the brain and nervous system to induce pleasurable effects and relieve pain. Addiction is a brain disease that causes an individual to pursue relief by substance use and other behaviors. Opioids killed more than 33,000 people in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid. The number of doctors penalized by the US Drug Enforcement Administration has grown more than fivefold in recent years. The agency took action against 88 doctors in 2011 and 479 in 2016. Missouri Senator Claire McCaskill announced that she was expanding her opioid investigation to focus her on the relationship between prescription drugs and the opioid epidemic. As a mental health clinician, I agree with her regarding looking deeper into the opioid epidemic. As prescribers we can help make a difference in the opioid epidemic by prescribing non-opioid pain medication. Also, prescribers should be held responsible when multiple overdose cases occur under their care and faulty documentation is present.

What actions on the state level are being implemented to reduce the opioid epidemic?

 On the state level, establishing and optimizing prescription monitoring programs, closing pill mills and increasing access to pain experts are currents efforts being taken. Nationally many health organizations such as the Centers for Disease Control and Prevention (CDC), DEA, National Institutes of Health (NIH) and Substance Abuse and Mental Health Services Administration (SAMSHA) provide funding for research, created an opioid overdose tool kit with sections for patients, families and medical providers, coordinate medication take-back programs and increase access to national education programs that raise awareness of the opioid epidemic.

What does this mean for prescribers? The CDC offers an interactive, self-paced learning, web-based training that provides case-based content, knowledge checks and integrated resources to help healthcare providers gain a better understanding of the opioid prescribing guidelines. It is my opinion that prescribers should take mandatory continuing education courses on safe opioid prescribing prior to prescribing opioids. As prescribers, it is our duty to remain abreast of the opioid crisis in the U.S. and to become knowledgeable on how to combat this opioid crisis. In 2015 nearly 2 million people had an addiction to prescription pain pills, this number is unacceptable. In addition to obtaining additional training specifically in opioid prescribing, each provider should attempt to check the patients name on the Prescription Drug Monitoring Program (PDMP) prior to refilling opioid prescriptions. Prescribers should consider implementing an overdose risk assessment tool prior to prescribing opioids to individuals on a long-term basis. Additionally, we can provide educational information to schools and in the community to educate individuals on the dangers of opioid addiction. We need to implement local task forces to aggressively curb the use of pill mills and prevent doctor shopping. We can divert individuals with substance abuse disorders to drug courts and rehabilitation programs. Provide overdose prevention in prisons. We can increase access to naloxone for emergency use in overdose situations and for high risk individuals. Who typically does not use the PDMP system? Prescribers that work in a pill mill environment typically do not utilize the PDMP system and continuously prescribe narcotics without regard to the safety of the patient or consider the risk of drug diversion. They continue to contribute to the opioid epidemic. Prescribers who advocate for patient safety will utilize the PDMP program to reduce the risk of prescribing opioids to a high-risk patient, identify doctor shopping and reduce the opioid epidemic one patient at a time.

What can you do to help? Support and advocate for comprehensive care for patients with a substance abuse disorder. Reduce the stigma associated with substance abuse. Prescribers can register their state PDMP and utilize it prior to prescribing opioids. Increase access to education on the dangers of opioids. Provide evidence based treatment options at the local and community level to help individuals with opioid addiction. Develop a local program for patients to safely dispose and discard dangerous drugs and opioids. Reducing the risk of opioid overdose is key an involves prevention by providing educational resources to the community, increasing access to opioid addiction treatment and rehab facilities. Someone in your home may be secretly battling an opioid addiction. One life lost from opioid overdose is one too many. The time is now to get involved in combatting the opioid epidemic.


Hawk, K. F., Vaca, F. E., & D’Onofrio, G. (2015). Reducing fatal opioid overdose: Prevention, 

treatment and harm reduction strategies. The Yale Journal of Biology and 

Medicine, 88(3), 235–245.

Nedelman, M. (2017, July 31). Doctors increasingly face charges for patient overdoses. 

Retrieved October 04, 2017, from


Opioid Overdose. (2017, August 29). Retrieved October 01, 2017, from

Substance Abuse and Mental Health Services Administration. Results from the 2013 national 

survey on drug use and health: Summary of national findings. (2014)

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