The facts about legal narcotics

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By Merilee Dannemann

The medical cost of prescription opioid abuse in the United States is estimated to be more than $300 billion a year. That’s billion with a “b.”

This statistic, which almost knocked me out of my chair, was presented recently at a conference of the New Mexico Workers’ Compensation Association by Dr. Charles Kennedy of Corpus Christi, Texas, an expert on occupational medicine issues. This part of his talk was subtitled “Pain Medication Crisis.”  

No kidding.

A few more statistics from Kennedy:

• The United States has only 4 percent of the world’s population, yet we consume 80 percent of the world’s opium supply and 99 percent of the world’s hydrocodone.

• Compared to non-abusers, opioid abusers were 78 times more likely to have a non-opioid poisoning. That’s 78, not a typographical error.

• Abusers were 36 times more likely to have Hepatitis A, B, or C and 21 times more likely to have pancreatitis. The national average for health care costs for an opioid user is $15,884 per year compared to $1,830 per year for the rest of us (based on a statistic from 2005).

To put these numbers in context, a report from the U.S. Department of Health and Human Services said the nation’s 10 most expensive health conditions cost about $500 billion to treat in 2005. In other words, costs related to opioid abuse were more than half as much as the combined total of heart disease, cancer, trauma, pulmonary disease and six other major conditions.

 We can’t measure the human cost in pain, suffering and the waste of life, not just to drug addicts but to their families and those around them. This is one piece of our national health care dilemma that is not only tragic and unacceptable but something we ought to be able to fix.

Some of these tragedies result from work-related injuries, which puts them into the workers’ compensation field, which I know something about. The drug abuse problem is common knowledge in work comp circles, but what to do about it is not clear at all.

In work comp, unfortunately, patients and doctors are sometimes suspicious of one another. So, according to the anecdotes, if the patient doesn’t get his prescription, he thinks the doctor is conspiring with the insurance company. That is not a basis for a healing relationship. Another common story is that some doctors prescribe pain medication because it’s less stressful for the doctor than explaining why it’s better not to give a prescription. But these are just two versions of a more complex mythology.

The numbers tell us that this is a much bigger concern for Americans than for people in other countries. Maybe all that drug advertising on TV has succeeded in brainwashing us into believing that any problem can be solved with a pill.

There are ways, including medications, to break the addiction. If you know someone with this problem, tell him and suggest he ask his own doctor.

There is another side to the opioid story that must be given its due: for some people, nothing else provides relief and for them, narcotics are a genuine blessing.    

Beyond that, there are just a few things we can say for certain: This problem exists in every neighborhood, probably including yours. And one essential of a successful health care system is patients who understand what’s happening to them. A health care system that measures the minutes of doctor visits and penalizes doctors who spend time with their patients is neither cost-effective nor logical.

Merilee Dannemann, New Mexico News Service 2010