Regarding the Feb. 15 story “The opioid abuse epidemic: How healthcare helped create a crisis,” sadly, most federal and state policies have largely missed the mark. Community awareness programs sound good but have not proved effective.
Increasing access to Naloxone and substance-abuse treatment is necessary, but by then, the horse has left the barn. The well-documented key to solving the epidemic is prevention. To prevent opioid misuse, we have to monitor patients more closely—look at what patients got (checking prescription-drug monitoring programs), what they took (toxicology testing), and what they have left (pill counts). It is about early detection leading to early intervention.
Yes, it means more work for prescribers and it may inconvenience patients, but there are programs available to address those challenges. Unfortunately, many physicians won't do the extra work on their own, not even in states where monitoring is now mandatory, let alone in states where monitoring is just a recommendation.
So we need leadership. We need leaders, both public and private, to force the issue, eliminating as much leeway as possible when it comes to monitoring patients and taking steps when aberrant behaviors are detected. Simply publishing helpful hints of how to be a better prescriber is insufficient and keeps us chasing this epidemic instead of getting in front of it.