CINCINNATI -- Many health professionals agree that a large portion of America's heroin epidemic began with doctors overprescribing opioid painkillers.
Here in Hamilton County, which this week saw over 90 overdoses in the span of just a few days, medical organizations are now looking for ways to re-train both doctors and patients to curb that dangerous trend.
"Physicians used to say, ‘Oh, it’s an acute problem, it’s no big deal; I’ll just write them enough,'” said Dr. Nancy Elders, who works with UC Health to steer other doctors away from overzealous prescription practices.
According to the National Institute on Drug Abuse, “opioids are similar to, and act on the same brain systems affected by, heroin and morphine, (and) they present an intrinsic abuse and addiction liability."
People who obtain these drugs may initially use them for their intended purpose, but become addicted to the sense of relief and well-being the medicine provides. When doctors prescribe more and stronger painkillers than a patient really needs, the potential for abuse grows exponentially.
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Doctors are part of the problem, but so, said Dr. Elders, are patients. A sick person who goes to the doctor’s office often wants to leave with something tangible, and patients who push for prescriptions are likely to get them, even in situations where they may not be necessary.
"I think a big problem is what, in our healthcare system, is covered by insurance," Dr. Elders said. "The easiest thing to get covered with insurance is a prescription. What do patients want when they go to the doctor? A prescription. We have to change doctors’ mindset of ‘Hey, it’s easy to write a script and get them out of here,’ and we also have to change patients’ minds."
Mimi Hart, who runs The Hart Pharmacy, said she’s been seeing a change in prescription rates already.
"We see that especially the emergency rooms are writing for smaller amounts (of painkillers)," she said. "In the past, they would write for 20 or 30. Now they’re writing for six or eight or 12 to get through the acute period until the patient can go see their family physician."
Ultimately, however, this system can lead to problems between doctors who fear overprescribing and patients who worry that they’re being deprived of treatment.
“Patients have this idea that narcotics, opioids, they’re the best," Dr. Elder said. "Anything else is, ‘You’re not giving me the best, doctor.’ So we need to do a mindswitch both among our physicians -- which I think is happening and has been happening for 10 years -- and among our patients."
Recalibrating expectations can be a messy process, but the Tri-State can’t afford to go back.