The Opioid Crisis: Who is really to Blame?

        Finger-pointing for this debacle and health crisis has been widespread, albeit skewed and unjustly zeroed on the medical community. In my opinion, much of it is unfair since I have yet to come across any reading that has taken a more objective in-depth look at the causative factor and asked unbiasedly why it happened in the first place. In other words, place the problem in its proper context by examining the genesis of this debated conundrum and ask ourselves– who is really to blame?.

        Critics have mostly blamed Big Pharma for their greed and the federal government & states for their poorly slow response to this devastating societal tragedy. But one would be remiss if the blame would go non apportioned accordingly, meaning forgetting to recognize or at the very least attribute other entities directly or indirectly responsible for this public health nightmare; to basically go one step further, right?.

So who else should be held responsible? Well, for starters how about JCAHO? The Joint Commission Accreditation Hospital Organization, the quasi-governmental bureaucratic agency that led the well intended campaign named “Pain the 6th vital sign”  back in the late nineties. Based on their researched studies, they spearheaded this idea/project & placed the healthcare industry in a very untenable position since the medical community had failed to address the undertreatment of pain for decades, thus pressuring medical providers to correct this deficiency in the management of chronic pain. Obviously this industrial guilt trip became deeply rooted leading to over prescribing.

By their views, we were told to step-it-up and so we did, because they told us so. Sadly and mistakenly, we failed to pause and reflect on the foreseeable consequences of this moral dilemma. Yes, we must and have accepted to shoulder this imperative responsibility in our clinical practices/careers. Unfortunately, this self-created malady is a classical example of “The Law of Unintended Consequences” – an undeniably painful reality to this day. 

The medical community has strived and will continue to do so when it comes to addressing & dealing with this complex clinical phenomena by becoming more educated & becoming more prudent prescribers. A work in progress to this day, but improving.

           As all stakeholders have become aware of this difficult problem, we should avoid this past pressurized demand. Furthermore, avoid singling out a particular group & stop pointing vilifying fingers. But more importantly, recognize & accept the fact we all played the “over prescribing role” in this disgraceful national opioid epidemic. Simply, we must do it.

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