“The Opioid Epidemic”

So what is the opioid epidemic and when did it all start? This conversation is always one of the hardest to have with new patients without making them feel judged on their first visit. This issue stems from the 1990’s and 2000’s when opioid manufacturers such as Purdue pharmaceuticals – the makers of Oxycontin – began to spread literature specifically in order to influence the prescribing habits of physicians in order to make more profit. Initially, it was widely believed that the risks associated with opioid use were minimal. Even one letter in the New England Journal of Medicine said that less than 1% of people on opioids would become addicted and that the benefits far outweighed the risks. Well, we know now this was a myth, up to 33% of all patients started on opioids end up in the difficult position of becoming dependent on opioids. In 2016, health care providers across the US wrote more than 214 million prescriptions for opioid pain medication—a rate of 66.5 prescriptions per 100 people. Even more frightening, is that 40% of the total 64,000 opioid related deaths in that same year involved a prescription opioid.

Once a patient has begun chronic use of opioids, I’ve seen how difficult it can be for them to quit, as I’ve helped several patients try to make this transition to non-habit forming medicines. Honestly, it takes a ton of coaching and frequent follow ups – it is usually a long road often with starts and stops. There are the lucky few who can quit “cold turkey” but for most it becomes a habit that can be as difficult (or harder) to quit than smoking. But, in my humble opinion, the life of opioid dependency is a miserable existence. I don’t think the any persons goal should be to set their clock for 6 hours from now just so they can take another pill, or to plan their vacations around their next doctor’s visit to get their next script. Who wants to live in this cycle of frequent urine drug screens and monthly visits to the physician just to get their triplicate? 

Therefore, every time I meet with a new physician I always tell them that we should work hard to use alternative methods to treat pain so patients never get started on the path to opioid dependence. And as for my patients, I understand that dealing with chronic pain wears on a person and that you worry that you will hurt today and tomorrow and that there is no end in sight. You may think that no-one “gets” how you feel and that they don’t truly understand what you have to go through. But while every person is indeed a unique individual remember that everyone has their own challenges and you may even know people in your life that are going through something similar. I’ve seen them and worked with them and helped them regain their freedom from opioids. 

The journey to healing and decreasing dependence on opioids starts with that first step of making the decision to change your life. I want to be the doc that helps you seize your day and live your life to the fullest potential. I want you to celebrate your grandchild’s adorably silly kindergarten graduation and create fantastic memories of finally taking that trip to St Petersburg where you promised yourself you would eventually go after retirement. 

In the end, I want to be there for you as my patient to help you transition to a narcotic free life. To experience many wonderful moments at home or around the globe. At times it won’t be easy. At times doubt and hesitancy will creep into your mind. But I truly believe that your life can be better with the the transition to medicines that are non habit forming and I want to instill within you the resolve to persevere. Let’s do this! Together.

-Mike Martinez II #DOFW