At first, the woman tried to hide her painkiller problem.
She told the doctor that she still had pain from her past pregnancy, and that
she just wanted a refill on her pain medication.
After a few questions, though, she admitted that a friend
had sold her some OxyContin, and that she’d stolen pills from another friend.
The interaction was all staged, with the patient played by
an actor and the doctor played by a medical student last month. The exercise
was part of a daylong boot camp at the University of Massachusetts Medical
School designed to help physicians in training identify and fight opioid abuse.
“There’s a lot at stake here. We have a public health
epidemic, and it’s not getting better, and the health care profession is part
of the problem,” said Michele Pugnaire, the medical school’s senior associate
dean for educational affairs.
Medical schools nationwide are rethinking their training on
opioids amid rising overdose deaths. Schools are taking action after critics
said they had inadvertently contributed to addiction problems. Federal health
experts say that physicians have been prescribing addictive opioid painkillers
too often, and that poor training is frequently to blame.
According to federal data, opioid painkillers were
responsible for nearly 19,000 deaths across the U.S. in 2014, an increase of
more than 400 percent since 2000. Heroin, by comparison, killed 10,000 people
in 2014.
“We are over 10 years into this epidemic, and I don’t think
we’ve seen a robust enough response from the medical community,” Michael
Botticelli, the White House’s drug czar, told reporters in Boston last month.
Studies have found that medical students at American schools
spend far less time learning to treat pain than their peers in other countries,
or even veterinary students in the U.S.
Most doctors– 99 percent — are prescribing highly addictive
opioid medicines for longer than the three-day period recommended, according to
a national survey. Twenty-three percent prescribe at least a month’s worth of
opioids.
According to a survey by the National Safety Council (NSC),
doctors overestimate the effectiveness of opioids. The survey found 74 percent
of doctors incorrectly believe morphine and oxycodone, both opioids, are the
most effective ways to treat pain. However, NSC research shows that
over-the-counter pain relievers such as ibuprofen and acetaminophen offer the
most effective relief for acute pain.
The Centers for Disease Control and Prevention (CDC)
recommends the three-day period. Evidence shows that 30-day use causes brain
changes.
Ninety-nine percent of doctors surveyed said they have seen
a pill-seeking patient or evidence of opioid abuse, but only 38 percent usually
refer those patients to treatment. Only five percent treat them for abuse
themselves.
The national poll was conducted among 201 board-certified
family or internal medicine physicians who spend at least 70 percent of their
time seeing patients in an office-based setting and treat patients for pain.
The fieldwork for the survey was conducted between March 5-13, 2016.
Other findings from the National Safety Council (NSC)
include:
- 71
percent of doctors prescribe opioids for chronic back pain, and 55 percent
prescribe them for dental pain – neither of which is appropriate in most
cases[v]
- 67 percent
of doctors are, in part, basing their prescribing decisions on patient
expectations; however, a National Safety Council poll in 2015 showed 50
percent of patients were more likely to visit their doctor again if he or
she offered alternatives to opioids
- 84
percent of doctors screen for prior opioid abuse, but only 32 percent
screen for a family history of addiction – also a strong indicator of
potential abuse
Associated Press writer Holly Ramer in Boston contributed
to this report.
