Opioid prescribing: the unintended affects

Opioid prescribing: the unintended affects

Posted:
LUBBOCK, Texas -


Texas continues to have one of the lowest rates of drug overdose deaths involving opioids. Doctors credit that to a stricter criteria process when it comes to prescribing these powerful drugs.

While cracking down on access to opioids is working, it has also affected a large majority of patients who are not abusers. 

"So I have a number of conditions, one of them is endometriosis. I also have ovarian cyst. I have psoriatic arthritis, which are all chronic pain management diseases," Jamie Needham said.

To manage this pain and simply get up in the morning, Needham is prescribed Norco, or hydrocodone. 

"So I use to be able to go to a doctors office and say I'm in pain and the doctor wouldn't look at me weird, or treat me any different," Needham said. "They would actually try to find the root of the problem, put me on pain medication so they could try to figure it out, and then start a better line of treatment."

That has changed. In the last six or so years, the Texas Medical Board, Federal Government, and Medical Society have each toughened up the criteria for getting these pain meds. But it has had some unintended affects of shaming these patients. 

"Even when you're not asking for it, doctors immediately assume something is wrong," Needham said.

Doctor Bolkar Sahinler with the Lubbock Spine Institute insists these changes had to be made.

"The sky is the limit was kinda the motto, and whatever the patient will tolerate, we're gonna give it to them until the pain gets better," Sahinler said. "Obviously we have realized that is not the right thing to do."

Needham said now she has to do a drug test every three months, be seen every three months, and cannot get a prescription unless she is seen.

Sahinler said instead of immediately prescribing pain medication, they look into multi-modeled treatments. 

"We spend a lot of time on diagnosing the true cause of the pain, and we spend a lot of time to get the patient moving, and increasing their daily activities rather than focusing on the pain," Sahinler said.

Sahinler said these practices have been working for his patients. Unfortunately, that is not the case for everyone.

"I'm in a group of friends who all take chronic pain medication for fibroids, or one of them has a mechanical spine, and she gets looked at like a villain," Needham said.

The villain label comes as a lot of people tend to mix up dependency and abusing. Sahinler said they are very different. 

"People are diabetic, they are dependent on their insulin," Sahinler said. "It doesn't make them bad people, It is what it is, the same thing goes for chronic pain problems time to time."

He said every patient is different and he is dedicated to coming up with a treatment plan that makes the most sense for that person. Sometimes, that includes taking powerful prescription drugs.

"More than 99 percent of patients that walk into the door are not abusers, they are just good people," Sahinler said. "They are hurting, and they are looking for a way out and a lot of them just come and say, what do I need to do?"

According to the CDC, on average, Texas providers are prescribing less than the national average. In 2017, doctors wrote nearly 53 opioid prescriptions for every 100 persons. That is the lowest rate in the state since 2006. 

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