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Why the STOP Act isn’t enough OR My ideas on resolving the opioid crisis

When I was in Raleigh over the weekend, I read a well-informed, well written article about legislation in the works that is designed to help curtail opioid deaths in North Carolina.  While the legislation is well intentioned and addresses some key areas, I don’t think it goes far enough.

Before I go into what I think is needed to resolve the opioid crisis, let’s first look at what the crisis involves.

Opioids are powerful pain medications that include OxyContin, Fentanyl and morphine.  Opioids are prescribed for intense pain.  Since 1999 there has been a fourfold increase in the number of opioid prescriptions written.  There has also been a fourfold increase in the number of deaths due to these drugs, with North Carolina near the top of the pack.  In 2015, nationwide, there were 17,000 deaths due to proper use of prescribed opioids.   There were 35,000 deaths reportedly due to all opioids, which includes street drug, such as heroin with 1500 of these occurring in North Carolina.

Opioids were initially prescribed for short term use, such as after surgery or for as palliative care for the pain of terminal cancer.  Later, well-intentioned medical doctors started prescribing opioid for long term use in conditions such as arthritic back pain, although there was little evidence that opioids actually work for this type of pain.  Many people’s lives have been ruined either directly or indirectly due to the epidemic past prescribing practices engendered. 

The Stop (Strengthen Opioid Misuse Prevention} Act would mandate smarter regulations for prescribing and dispensing controlled substances, provide for greater funding for drug-addiction treatment and would allow for greater community access to Naloxone, a drug that when used in the case of an overdose, immediately reverses the effect of the opioid, thereby saving lives.  While I think it is important that proper prescribing practices are adhered to and that there is access to recovery services, the STOP act, and almost everything else put forth from our government agencies such as the CDC does little to prevent the problem in the first place.

Many medical doctors prescribe opioids because they do not know what else to do.  They have exhausted all their typical avenues of approach for pain: NSAIDS, such as ibuprofen, steroid injections, nerve blocks and PT.  In October of 2015, a medical organization called P.A.I.N.S. (Pain Action Alliance to Implement a National Strategy) published a policy brief recommending non-pharmaceutical interventions prior to prescribing for low back pain.  The interventions recommended included massage, acupuncture, chiropractic care, yoga, meditation, dietary changes, herbs, relaxation and even getting out in nature. 

More recently, the American College of Physicians and the CDC have come out with statements encouraging non-drug treatment of low back pain, such as “spinal manipulation” which means chiropractic care.  I have yet to see any of their recommendations be put into effect.

Until we take a stand against drugs for every little thing that ails us and use proven care that works, such as chiropractic care and dietary changes, then the opioid epidemic, as well as the over use of all other drugs from antibiotics to beta blockers, will continue.  Our health will get worse, the care we get will get worse and the costs will continue to sky rocket.  You can take charge now by giving us a call at 336-766-0888 to schedule a time for us to talk so I can see how I can help you have abundant health.

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