To a hammer, everything looks like a nail.
This maxim comes to mind when observing how some in the state want to address Mississippi’s opioid and heroin crisis. It is tempting to look for a simple solution to the problem without placing it in context with its complicated, harsh reality.
For instance, some want to target prescribers, which ignores the larger issues in play. After all, just hammering away at prescribers will not plug the drug pipeline.
Our focus at the Mississippi State Medical Association is different. We use evidenced-based medicine to make decisions, and the science now tells us to shift patients in long-term chronic pain away from opioids. But, it’s more complicated than that because, at the same time, we must also provide a path to recovery for addicted patients.
There simply aren’t enough affordable addiction recovery centers in the state to provide the help needed by those struggling with this disease. If recovery programs were available and accessible we would see fewer patients diverting drugs for illicit use and desperately seeking heroin and similar solutions on the street. After all, we didn’t get here overnight and we won’t solve this problem in a day.
The physicians of the MSMA are doing more to police ourselves, retraining to change prescribing patterns and to move toward over-the-counter remedies for patients with chronic, non-cancer pain. Naturally, pain patients still demand opioids and we prescribers need treatment options to wean them off narcotics — especially when recovery programs are unavailable or unaffordable. We also are vigilant and constantly telling our members to use the Prescription Monitoring Program and the opioid guidelines published by the Centers for Disease Control and Prevention.
If we stay mired in a simplistic world view, we condemn those who are addicted to repeat the same dismal pattern: The jail. The street. The morgue.
Let’s stop being hammers. Let’s approach this problem together from all fronts. Mississippi can do better. And prescribers are part of that unified solution.
Dr. Lee Voulters, a neurologist practicing in Gulfport, is president of the Mississippi State Medical Association.