In 2016, an estimated 2.1 million Americans were struggling with opioid addiction. In the fight against opioid dependency, physicians play a vital and challenging role to help their patients heal and cope with their pain while minimizing their reliance on narcotic and opioid medications. Thankfully, most Bay Area doctors take these obligations seriously.
What Are Opioids?
Opioid medications are synthetic and semi-synthetic narcotics that can help treat severe pain. While opiate and opioid medications have existed for centuries, many doctors were hesitant to prescribe them after the 1970s heroin epidemic.
In the late 1990s, a series of medical studies suggested opioid medications were not highly addictive and advances in modern, synthetic opioids helped shift medical opinions about chronic pain management. By the early 2000s, most physicians believed short-term use of opioids — such as oxycodone, morphine, fentanyl, and hydrocodone — posed very little risk of dependency. They were wrong.
By 2016, 116 Americans died every day due to opioid overdoses. In 2017, the Department of Health and Human Services designated opioid addiction as a public health emergency.
Northern California Is Deeply Impacted by the Opioid Crisis
While California has lower opioid use rates than many states, thousands of Californians suffer opioid-related emergencies each year. The statistics are grim:
- Between 2011 and 2014, California’s number of heroin-related deaths and emergency room visits both increased by almost 40 percent.
- In 2016, there were 1,925 opioid-overdose deaths in California.
- Emergency departments had 4,623 opioid overdose visits statewide in 2016 (excluding heroin-related visits).
Bay Area Doctors Are Building Tools to Treat and Fight Opioid Addiction
Thankfully, the Bay Area medical community is actively combating opioid addiction through improved medication policies, thorough research, and innovative treatment options that focus on coordinated care and integrative health.
East Bay Safe Prescribing Coalition
In 2016, the hospitals in Alameda and Contra Costa Counties formed the East Bay Safe Prescribing Coalition. Every emergency department in those counties voluntarily adopted guidelines aimed at reducing opioid addiction. The coalition includes members of Canopy Health’s alliance, including Alameda Health System’s three hospitals (Alameda Hospital, Highland Hospital, and San Leandro Hospital), John Muir Health – Concord, John Muir Health – Walnut Creek, and San Ramon Regional Medical Center.
Under the coalition’s guidelines, emergency rooms will:
- Only provide limited amounts of narcotic pain medications (when appropriate)
- Not refill lost or stolen prescriptions or prescribe long-acting medications such as Oxycodone, Methadone, or Fentanyl
- Not give patients missed doses of drugs that treat opioid addiction, such as Subutex, Suboxone, and Methadone
- Check California’s statewide drug monitoring system (CURES) before prescribing opioid medications or other controlled substances
- Prefer oral medications over injections for chronic pain issues
- Encourage coordinated pain management for all patients
Emergency departments are also offering referrals to outpatient substance abuse programs and other addiction resources.
Cutting-Edge Opioid Research
UCSF Medical Center and other Bay Area medical facilities are at the forefront of ongoing research into opioid medications, addiction, and alternative treatments. Researchers and physicians are working to create medications that are as powerful as opioids but are non-addictive. Others are studying the impact of integrative health services on chronic pain.
Coordinated, Patient-Focused Health Care Can Reduce Opioid Abuse
The risk of opioid addiction and dependency increases when there’s limited communication between a patient’s medical providers. When a single physician oversees your medical care, he or she can help you avoid overmedication and identify drug-free treatment options that might reduce your pain. Your physician can also help you address existing substance abuse issues.
Integrative health care, which focuses on the whole person rather than a symptom or single diagnosis, can also help patients avoid opioid dependency. For example, people with severe anxiety typically experience higher levels of pain. If a doctor treats a patient’s pain complaints but ignores underlying behavioral or mental health problems, pain management might be difficult. And while not everyone benefits from biofeedback, acupuncture, and other complementary, non-pharmaceutical treatments, they pose very little risk to the patient.
California Opioid Overdose Surveillance Dashboard (2018, March 14). Retrieved from https://pdop.shinyapps.io/ODdash_v1/
May, P. (2018, January 10). How does California fit into the opioid crisis? The Mercury News. Retrieved from https://www.mercurynews.com/2017/10/26/how-does-california-fit-into-the-opioid-crisis/
U.S. Department of Health and Human Services (2018, March 6). About the U.S. opioid epidemic. HHS. Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html#us-epidemic