Can we afford to fight the opioid crisis? With the devastation meted out from the epidemy, perhaps the most appropriate question is “can we afford not to?”
By Carl Callison – Before addressing the opioid crisis, one should identify what its root causes are. In this case, there are two of them. The first one obviously lies in our capacity to develop strong cravings for a number of things and our inability to recognize our problem before it becomes a full-fledged addiction.
The other cause of the opioid crisis is greed.
Over the last 25 years, greed has crept into all aspects of our economy and lives. As an executive with a large health insurance company, I saw it with the billing practices of certain healthcare providers as well as the excessive salaries paid to hospital administrators, medical practice executives and leaders of health insurance companies and drug manufacturers.
The greed factor associated with the opioid crisis is even more pervasive and despicable because it impacts the health and welfare of individuals, their families, communities, law enforcement and all levels of the government. So, who is perpetrating and benefiting from this greed? It is certain physicians and medical clinics who write excessive numbers of prescriptions for pain medications as well as pharmacies which dispense huge numbers of drugs. And, we cannot forget pharmacy manufacturers who are more than willing to provide outlandish volumes of the most popular pain medications through wholesale distributors..
In a small town in Southern West Virginia, a local pharmacy received 9 million pills in two years. That’s almost 11,500 pills per resident per year!
In 2016, reporters at the Charleston Gazette-Daily Mail in West Virginia, analyzed shipment data and found that three major drug manufacturing companies made $17 billion by sending 423 million opioid painkillers to West Virginia between 2007 and 2012. Six of the 55 West Virginia counties have the highest death tolls resulting from opioid addiction in the country. Over six years, almost 2,000 patients died from overdoses on hydrocodone and OxyContin. This in a state with a population of about 1.8 million.
The Gazette-Mail also found that in one town in southern West Virginia, with just 392 residents—a single pharmacy received roughly 9 million pills over a period of two years! That’s almost 11,500 pills per resident per year! I could elaborate on their findings, but obviously the doctors were prescribing a lot of pain pills, the pharmacy was ordering them and the pharmacy wholesale distributor was delivering them. Ironically, these same distributors blame doctors for the addiction epidemic, but drug manufacturers began advertising their medications as suitable for patients with chronic pain in the 1990s, and doctors began prescribing them liberally. Prior to that time, opioids were only prescribed to patients in a lot of pain near the end of their lives.
So what must be in a plan to address the root causes of the opioid crisis: addiction and greed? Simultaneously, two things must be done. We must establish and evaluate the best methods for treating and providing rehabilitation for those who are addicted. Secondly, we must through a variety of measures, substantially reduce the supply and number of opioid pills being ordered by doctors, dispensed by pharmacies and delivered by pharmaceutical wholesale distributors.
To treat and rehab the addicted, significant resources will be required from all sectors of our country. Federal, state and local governments must be willing to provide sufficient funding to public and private organizations that have established and documented best practices for treating the addiction and enabling individuals to return to society as productive citizens.
To reduce the number of individuals becoming addicted to opioids, the Federal Government and all players in the medical field must come together and establish policies for reducing the number of opioids being manufactured and made available to patients with chronic conditions. This should include an analysis, policy and criteria for determining the type medical conditions treated with opioids.
Can these things be done? Yes, but only with the cooperation and participation by a large number of entities whose motives are not always in parallel. Can we afford to take this action? Perhaps the more appropriate question is “can we afford not to” with the devastation being meted out from the opioid crisis?
About the Author
Carl Callison was graduated from West Virginia University Institute of Technology and after working five years as a Federal Auditor for the US Department of Health Education and Welfare began a 35 years career with West Virginia’s largest provider of prepaid healthcare benefits.
During his 35 years with Blue Cross and Blue Shield, Carl served in several executive positions including sales, marketing, Federal Programs and internal operations. In his last role with Highmark Blue Cross Blue Shield West Virginia, Carl served as Director of Corporate Planning, Communications and Public Relations. In this role, Carl worked with government officials as well as healthcare decision makers charged with controlling the cost and improving the delivery of healthcare in West Virginia. Carl also served as a leader on a joint legislative task force charged with evaluating and improving healthcare in West Virginia.