Tuesday, April 18, 2017
In 2011, the CDC declared a prescription drug epidemic that was sweeping through the entire U.S. This book goes in depth, discussing the relation between illness and prescription medications, specifically mental illness and drug addictions. The drugs given to patients with mental illness are extremely addictive for everyone taking them. If abused, the patient could suffer a very hard process of having to kick the addiction thus resulting in ending the medication that was originally used for treating their mental illness.
Even though patients are given prescriptions by licensed doctors, some prescriptions are written much easier than others. Doctors may over prescribe or overlook the addiction their patient is facing. Ann Lembke, Chief of Stanford Addiction Dual Diagnosis Center, was part of the prescription drug addiction problem and had no idea until technological advancements were made available in California. This advancement was known as the Prescription Monitoring Program. This Program allowed her to see prescriptions other doctors were giving her patients. During her time in medical school, Dr. Lembke was taught that drug addiction wasn’t an illness, therefore, it wasn’t her job to treat the addiction. She believed the addiction must be addressed and solved before she could begin to treat the patient’s mental illness. After seeing her patients come to her office asking for more medicine of higher doses, a switch flipped in Dr. Lembke’s head. She noticed her patient’s mental health wasn’t getting any better. After looking at the Prescription Monitoring Program, she realized some of her patients were receiving the same prescriptions from as many as 10 other doctors. She concluded that the issue had to be addressed and it was now her job to treat her patients for drug addiction so she could then address the mental illness.
Ann Lembke states the reason for the epidemic was due to Purdue Pharma joining forces with the Joint Commission. This collaboration was done in part to prevent pharmaceutical companies from going straight to the doctors when trying to get them to sell their drugs. This eliminated the pharmaceutical companies from bribing the doctors to promote and prescribe certain drugs to their patients. The Joint Commission accredits the hospitals while Purdue gave them all the teaching material to put in the hospitals. This teaching material emphasized treating pain more proactively and effectively. This material also taught doctors that opioids were not addictive as long as the patient was experiencing pain. In addition, doctors were under the impression that the opioid Oxycontin, which was created by Purdue, wasn't an addictive agent. As the number of cases of addiction increased, the Department of Justice took notice and charged Purdue with misbranding the drug's abuse potential. In 2007, Purdue pleaded guilty and paid over $600 million in fines for misbranding Oxycontin. Because of this, the FDA refused to approve generic versions of the original formulation.
The teaching material offered by Purdue led to the pain scale were doctors asked patients to rate their pain on a scale of 1 to 10. If the Doctors didn’t treat the patient's pain, they weren't doing their job as a doctor. The Joint Commission would find this out from surveying the patient after discharge. The hospital and doctor would be seen as not doing what they need to do to take the patient out of pain. This leads us to the discussion of how the world views pain. The philosophy of pain has changed over the past 100 years and contributes to the epedimic. I will discuss the philosophy of pain in my next post.