"Mad Hatter"American Governments Over one-third of people in the United States have experienced pain in the last three months. Of those, 25.3 million experience pain daily. Many of these people turn to opioids as a fast and effective way to relieve their pain. And with doctors readily prescribing opioids, more and more Americans have become addicted to their effects. The United States is facing an opioid epidemic due to the negligence of big pharmaco in the late 1990s. Pharmaceutical companies assured doctors and patients that they wouldn’t become addicted to opioid pain relievers. This caused a sharp increase in their rate of prescription, in fact, rates have quadrupled. In 2017 an estimated 47,600 people died from opioid overdose, 11.4 million misused prescription opioids. Of those prescribed, 21-29% of people misuse their prescription and 8-12% will develop opioid disorder (Public Affairs). The majority of the 11.4 million that misused opioids report doing so to relieve physical pain. However, a large portion report using them to get high (11.7%) or to relax and relieve tension (10.9%) (Lipari, R., 2017). Recently, a lawsuit against a large manufacturer of opioids was settled for $270 million for the deaths and societal damage this misinformation has caused (Hoffman, J., 2019 ). In 2016 the CDC released prescribing guidelines to prevent the overprescribing from doctors. Included in their guidelines is to turn to use physical therapy as a means to prevent and treat pain symptoms especially for musculoskeletal pain such as low back pain and osteoarthritis (MoveForwardPT, 2018). This is a call for doctors to recognize the role of physical therapists in the opioid epidemic.
Additionally, the opioid crisis is merely a symptom of a larger problem that needs to be addressed: the apparent lack of holistic and preventative care due to the holes in access to affordable healthcare. In the United States, health coverage is attained through your employer, purchasing it yourself, or government programs. There are typically three different categories of insurance that vary cost and in freedom to choose your healthcare provider. In general, from highest cost and most freedom, to least expensive but least freedom to choose, the three plans are: fee-for-service plans, health maintenance organizations (HMOs), and preferred provider organizations (PPOs). For people with disabilities, government aid is an option in the form of Medicaid and Medicare. Each type of insurance will cover either a certain dollar amount or percentage of specified medical expenses. Not all doctors, medications, treatments, therapies, or medical equipment are covered. Furthermore, to obtain physical therapy sessions, many insurance policies require a provider to confirm that physical therapy is medically necessary. This places the responsibility on the doctor, rather than the physical therapist, to judge when physical therapy is necessary or not. This highlights the importance of educating prescribers when opioids versus physical therapy are warranted. It also signifies the priority of educating patients of their options when faced with injuries. Election Impact: There are two levels of government we must look at to observe how recent elections have impacted this issue: the federal level and the state level. The federal government has the power to give funding and grants whereas the states can regulate who prescribes it and pass legislations. The midterm elections in November 2018 passed multiple bills in hopes to have an effect on the opioid epidemic. To help current addicts, funding for new treatment programs, new recovery centers, and different payment options for patients were all addressed in the bills. Additionally, Congress guided the National Institute of Health to develop alternative non addictive painkillers. (Walden, & Greg., 2018.) The Affordable Care Act was passed in 2010 and came into effect in 2014. It aimed to address the overarching problem of accessible and affordable healthcare. It roughly halved the amount of uninsured individuals due to the expansion of Medicaid eligibility. However, not much has been done to expand this act any further and, in fact, Medicare access has been declining. (Healthcare.gov) In California, Jerry Brown passed Senate Bill No. 1109 in September 2018. This bill focused on prevention via educating the public about precautions and dangers of opioid use. Additionally, it requires prescribers to participate in continuing medical education in order to maintain updated information regarding risks and alternatives to opioid prescription. (Caiola, S.) Conclusion: The overarching problem of the opioid crisis appears to be rooted in American’s access to healthcare. If healthcare were more readily available and affordable, patients would likely be able to receive the care they need, when they need it. This would prevent injuries from getting too severe and likely needing opioid prescriptions as chronic injuries increase the risk of long term opioid usage. Additionally, the quality of healthcare needs to be improved. This is being addressed by government by requiring providers to receive continuing education of the dangers of opioids and the addiction crisis and the encouragement to use physical therapy as a means of long term pain relief and injury prevention.
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AuthorUndergraduate student generated content. Blog posting and updating done by Kristina Flores Victor, Assistant Professor of Political Science at CSUS Archives
March 2020
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