Opinion: How We Created The Opioid Epidemic & How To Solve It
In practically every society addiction is frowned upon. It’s a sign of weakness, and bad morals, but really it’s a disease. Nurses and Physicians have been tasked with the goal of promoting health and helping individuals be their optimal selves. But what happens when the system created to protect you makes you the very addict they despise?
Dilaudid, once a opiate medication used for excruciating pain and primarily in those coming out of surgery somehow made its way into emergency rooms all over America, treating conditions as minor as an uncomplicated headache to an ankle sprain. What happened??? How did this highly addictive drug, compared to Heroin become so easily accessible?
I’ll tell you how, when hospital executives realized that their funding and reimbursement would be based on customer satisfaction scores. The push to satisfy patients has hit an all-time high, and it’s compromising patient safety. One of the most asked questions in the surveys that patients take post discharge ask in several different ways; was your pain managed, were you comfortable, and did your nurse address your needs when it came to your pain.
Patients would answer these questions negatively due to many variable factors that is no fault to a hospital or its providers.
For example, patients suffering from chronic pain will never be pain-free, so how could they answer yes, and most patients who stay in a hospital overnight and are conscious will never be fully comfortable given the amount of alarms and interruptions to their rest that will take place during their stay. But with the push of increasing scores, so came the motto “give the patient whatever they want” and “the patient is always right”. Due to this way of thinking and the pressure on physicians and nurses to achieve high scores for hospitals, Doctors began to order an obscene amount of opiate medications to satisfy their patients despite their history of drug abuse, hospital shopping, prescription fraud, and substance abuse. “The customer is always right” is used in retail, and healthcare has adopted it. If the patient was always right, why would they be seeking expert help?
Doctors and Nurses make educated decisions everyday to serve patients in the safest most compassionate way. You can not go to the bank and ask to withdraw ten thousand dollars if you only have five hundred in your account. Patients should not be allowed to ask for the strongest most addicting pain medication when their condition doesn’t warrant it. The word of Diludid being given like candy on Halloween in the Emergency Department spread like wildfire, and even those persons without a history of addiction or abuse became interested in the hot drug and would request it to give it a try and become addicted. The opiate addiction problem in America has become so bad that patients have overdosed while in the hospital. That’s insane!
To have an overdose during hospitalization while under expert care sounds absurd, yet it happens all the time. Patients end up on ventilators due to respiratory depression, a common side effect of opiates. So how do we fix this problem, and why did it take so long for the healthcare industry to realize they created this problem? The very cause of the opiate addiction problem was one of financial gain, and it back-fired and resulted in financial loss. When clinical decisions are made by businessmen and not clinical experts, epidemics like this occur.
When will hospitals realize the best way to save money and improve customer satisfaction scores is to provided safe, compassionate and competent care? It’s really just that simple.
This post was provided by Patricia “Nurse Patti” Lafontant, MSN, RN. She is an Emergency / Trauma Nurse.