Is It a Coincidence That the Opioid Crisis Grew Under the Affordable Care Act?

Each day, opioid abuse claims hundreds of lives. It's a devastating crisis that has shattered families and communities across the country. As a doctor and chairman of the subcommittee on health on energy and commerce, U.S. Rep Michael Burgess, R-Pilot Point, is in the midst of hearings to develop legislation to address the medical and social issues of opioid abuse. Burgess met with members of the editorial board to offer some insight.How did opioid abuse become such a crisis? That's one of the things we are trying to delve into. Was it a phenomenon because a manufacturer decided to deliver a bunch of medicine to an area and then it got pushed out the doors? It bothers me that we [doctors] could have been part of this problem. One of the very first hearings that I ever attended in the health subcommittee of the energy and commerce committee was in 2005. The issue then was why weren't doctors prescribing adequately for pain relief. Remember pain became the fifth vital sign, an indicator of quality and whether it was satisfactorily dealt with. When the Affordable Care Act came through, additional weight was put on those scorecards. These are powerful medicines and can do a great job of alleviating pain. That's one thing that a physician should do. That was always the mantra we followed. But anytime you wrote a prescription, it was always in the back of your mind. This is a compound where habituation can occur. Particularly for chronic pain?Why don't we have better stuff for chronic pain? Opiates are great for short-term relief. I operate on someone, I send them home with a dozen or two dozen pills because I want them to be comfortable for that first week or ten days after surgery. But you don't just refill it, refill it, refill it indefinitely. I don't know where that occurred. Percocet, Oxycontin or one of these compounds was standard issue. But that doesn't explain the volume of pills that have been going out. If it was just a problem of physicians, perhaps educationally, we could get a handle on that.  Continue reading...

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