SOUTH PORTLAND — Kudos to Gov. LePage, who has made the opioid drug crisis in the state of Maine a top priority for his administration.
He is working closely with the leadership of the Legislature to come up with creative, innovative solutions to this problem, which is destroying and devastating so many lives. He has formed a task force to advise his administration on possible solutions. He’s proposed requiring Maine doctors to use the Prescription Monitoring Program before prescribing opioids.
Thinking outside the “script” will be needed to solve this epidemic of human destruction. The problem is beyond calamitous – it is the equivalent of a modern plague of “Pharmagedon.”
How bad is it? According to the U.S. Centers for Disease Control and Prevention, 259 million prescriptions for opioid painkillers were written in 2012: almost one prescription for every adult.
As a result, the CDC reported, 46 people die per day in the U.S. from overdosing on prescription painkillers. If any other issue caused this many deaths, there would be no limit to the mobilization of resources to combat it.
Though the United States has 5 percent of the world’s population, we consume 75 percent of the world’s opioids, the U.N. Office on Drugs and Crime has found.
Taking a global view of this epidemic, one could easily ask: For what ailments are opioids prescribed? Ironically, the majority of the prescriptions are for chronic pain from musculoskeletal disorders. They are back pain (30 percent), extremity pain, osteoarthritis, fractures, neck pain and headaches.
In Maine, the majority of health care is delivered by five corporations. They are MaineHealth (Maine Medical Center), Eastern Maine Healthcare (Mercy Hospital and Eastern Maine Medical Center), Central Maine Healthcare (Central Maine Medical Center), InterMed and Martin’s Point. They provide billions of dollars of health care services each year.
What do these corporations have in common? None has alternative health care practitioners on their staff. The only medical center with a chiropractic physician on staff is the Veterans Affairs hospital at Togus.
Why is the public restricted from the opportunity to receive proven alternative health care services when they seek pain relief at the facilities owned by these corporations?
After careful review of the research and evidence, the CDC and American Public Health Association are advocates of conservative, non-pharmacological pain treatment alternatives, including chiropractic services, acupuncture, meditation, yoga, anti-inflammatory diet recommendations and exercise.
Gov. LePage should mandate that a chiropractic physician be part of the triage team to initially evaluate patients seeking pain relief for musculoskeletal disorders. They should be in each emergency room and hospital as a specialist in musculoskeletal disorders. The education and training of doctors of chiropractic make them uniquely qualified, and every study reveals a high level of patient satisfaction.
This proven alternative approach and input to the evaluation of the patient will help direct the type of care the patient should receive. This can range from very conservative care to more invasive care, always beginning with the most conservative approach.
This innovative non-pharmaceutical approach may not be well received by Big Pharma as we work together to try to limit the number of painkillers prescribed. This is a stark contrast to the current approach to pain management. On the fiscal side, hospital administrators may have issues: Will this approach increase or decrease revenue?
A paradigm shift in health care is upon us. The old model is “the more you do, the more you make”; the new one is “the less you care do with outstanding outcomes, the more you earn.”
Chiropractors collaborate with our medical and osteopathic colleagues coordinating care for our mutual patients on an outpatient basis. There are many cross-referrals between the professions. Working side by side will only help the professions understand how each of us looks at and evaluates the patient’s best treatment options.
The health care model of tomorrow will mandate collaboration, integration and innovation, such as at Togus, where doctors of chiropractic are integrated into the Veterans Affairs practice. This non-pharmaceutical approach has proven effective for our veterans in the management of many of their musculoskeletal disorders.
There are many examples of chiropractors and medical doctors working together. Most major colleges have chiropractors on the medical staff; so do all of the major professional sports teams. Chiropractors travel with the PGA and the Olympic team. Congress also has a chiropractic physician on staff.
I believe these innovations, while disrupting the status quo, will eliminate the need for unnecessary opioid prescriptions and the potential for painkiller addiction.
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