Pubdate: Wed, 14 Sep 2016
Source: Wall Street Journal (US)
Copyright: 2016 Dow Jones & Company, Inc.
Author: Robert Taylor Seagraves


There is a danger in doing something to solve a problem without fully
understanding the possible consequences of such actions ("States Fight
Opioid Epidemic With Data," U.S. News, Sept. 3). I am acutely aware of
the problems with the current opioid epidemic. A 26-year-old patient
of mine recently died of an unintentional heroin overdose. I am also
acutely aware of the law of unintended consequences in medical policies.

Not so many years ago, pain was declared the fifth vital sign. Medical
charts had faces ranging from smiles to frowns to register patient
discomfort, and staff routinely inquired as to pain experienced by
patients. This movement, led by medical leadership, of course,
resulted in more prescriptions of opiates. Subsequently, medical
leadership became aware of the risk of opiate overprescribing, and
pressure is increasing to reduce opiate prescribing. After many
physicians became reluctant to continue prescribing opiates, some
patients purchased illicit opiate medication from dealers. As the
supply of illicit opiates decreased and the price escalated, patients
then turned to heroin, which is cheaper and lasts longer.
Unfortunately, heroin from dealers frequently is mixed with fentanyl
and other substances such as carfentanil. Deaths from heroin overdoses
have escalated. One can only speculate how many young lives are being
lost because of changes in medical policy.

Robert Taylor Segraves, M.D., Ph.D.

- ---
MAP posted-by: Matt