Last night I watched “Last Week Tonight” with John
Oliver, where he talked about the opioid abuse epidemic that is occurring in
the United States. The topic is heavy
but he lightens it with some political humor.
I would encourage you all to watch it, because besides the humor it is
unfortunately accurate:
This topic hits me hard because I peronally know someone who is addicted to opioids. Every time I
hear the topic brought up I want to ignore it, pretend it’s not happening, and
deny that it’s an actual problem in the States.
But the said truth is that it is a problem, a big problem. It makes me mad to think how big pharma companies
(cough Purdue Pharma) can get away with this sort of unethical, unmoral, and most
importantly harmful behavior. I couldn’t
help but think about those readings on Transnational Corporations (TNCs) we had
a few weeks ago. That this business has
the same rights as individuals, and that they are just running a business. They have a product (Oxycotin), they market
it (heavily), and they have become very successful.
However, fingers can’t be pointed in one direction. I feel the issue is systemic. Under the new healthcare system (the ACA),
physicians are reviewed based on quality versus quantity (aka on number of
procedures, patients, lab tests, etc.); this is referred to as “pay for
performance” [1] and is better than the old system, for the most part. The problem lies when the United States is
one of only two (think about that – there are 196 countries on Earth), that
allows direct-to-consumer drug ads [2]. Patients
see these ads on television or in magazines or literally anywhere, with the
friendly notion to “Ask your doctor about…”. These patients enter the family practice or
hospital setting and feel empowered to ask the physician for these drugs,
specifically in this situation opioids, and would probably rate their
experience and satisfaction as low if they did not receive these drugs that are
marketed to be “life-changing” [3]. The
physicians are then put between a rock and a hard place. The patients are unknowingly in the same
position as well, having to choose between living with pain or living with
addiction. In my experience in my
nursing capstone in the Emergency Department, it was not uncommon for me to
encounter (excuse any stereotype) drug-seekers, most commonly opioid-seeking
patients. The reality is sad, these
patients are undoubtedly experiencing pain, but opioids are addictive and
harmful and easily abused, and NOT the correct medication for most pains (excluding
end-of-life treatment and cancer pain).
I have some recommendations of my own (for when I become
president and change the world of course), but I want to hear yours. What could or should be done to reverse this epidemic? And since this is an international health
class and not just a public health class, do you feel this is a global health
issue? Are public health students in the
UK studying this epidemic in America thinking “yikes.. they have a really public
health issue”? Should international
organizations become involved (i.e. WHO)?
Lisa,
ReplyDeleteI really enjoyed your post. It was very alarming and informative. I did not know how big of an issue this was! The comparison between 2005 and 2014 is ridiculous. Did the US become one of the two countries that allows direct-to consumer drug ads, somewhere in the middle of these two years and the high incidence rate of opioid use is a direct result of this?
In order to reverse this epidemic I think we need to find the root of the problem- why are so many people using opioids? Is it because of these ads and easy accessibility or is it because stress levels have risen? If this increase in use occurred after the ads were legalized, how to policy makers not see this correlation as a problem? Then, we need to find alternative ways for people to handle their pain.
Relating this to international health, I think other countries can learn from our mistake of allowing these ads! I am interested in what other country allows these ads and if their rate of opioid use is just as high.
Lissa .. Thank you for raising this topic. I really enjoyed your post!
ReplyDeleteHannah .. I totally agree with you!
Although it is sad, I believe that this problem is a threatining global issue that become exaggerated because of globalization and the related neoliberal ideologies. Dealing with citizens as consumers rather than social citizens is a major problem. In my opinion, policy makers don't pay attention to the legal Ads problem because of the political and economic benifits which actually ruin those who suffer pain and look for any possible solution to relieve their pain and suffering. It is a must that physicians should look for alternatives, but in my opinion the problem will continue as long as there is no political and economic attention. I totally agree that International organizations as WHO should be involved to raise and highlight the issue, take the lead and work with different agences and governments trying to put a halt to this global threat.
Hi Lisa,
ReplyDeleteI have seen several documentaries/specials on this issue as well (I'd have to search around for what the names/sources were) and it is interesting to me that the perspective coming through in the one you referenced involved blaming direct to-consumer advertising. My understanding from what I had seen was that an initial lack of understanding of the potential for abuse when these drugs first came to market, coupled with over-prescription by doctors who would rather just write the script than try to explain alternatives to their patient, was the root of the problem. Bringing the question of advertising into the issue makes me wonder about this practice, and not just as it applies to opioids. As far as the opioid issue... perhaps I don't watch enough TV or read enough magazines, but I feel like those are not the subject of most or even many drug ads. Common conditions like diabetes, high blood pressure, high cholesterol, and ED seem to show up far more. It is interesting to me that the US is only one of two nations that allow drug companies to advertise to consumers. While this could be problematic if it is contributing to the opioid epidemic, I think these types of advertisements also give patients a sense of control over their health. These ads tend to be for prescription drugs, so it is not as if the advertisement can spur someone to go to the store, stock up, and misuse; rather, it can remind patients to ask their doctors about certain drugs that they think may work well for them, which will then spark a conversation about a customized care plan. I guess the root of this question is whether advertising -- of meds, food, cars, political candidates -- should be seen as overly controlling and influential, or as a source of information about products/services/opportunities available.