Lessons from the opioid crisis, a case of overtreatment with devastating consequences

Cristina Roure
 

If you are regulars of American series such as House, The Affair or This is us, you will be familiar with the classic protagonist who, after an episode of acute pain, ends up becoming addicted to prescription opioids such as Vicodin®, OxyContin® or Percocet®. Do not think that this is a writer’s exaggeration.

In 2015, life expectancy in the United States changed the trend and began to decline for the first time since the First World War. Among the causes, the epidemic of deaths from opioid overdoses, which multiplied by six between 1999 and 2017 (1), surpassing deaths associated with AIDS at its worst or those related to the Vietnam War. The epidemic was declared a national emergency by the United States Department of Health in 2017 and, despite the campaign deployed to combat it (2), 130 people still die in that country every day from opium overdose. If you are interested in the subject and want to delve into it, read the supplement that Nature dedicated to it in September last year.

Training is essential for change management

Nacho Vallejo

The actors who intend to get involved in the orchestration of changes in our healthcare system tend to agree on the difficulties and barriers that limit the development of improvement strategies for healthcare organizations. We have already seen it in previous posts on this blog, where we asked ourselves what has become of the professional's experience and how to "unclog" our institutions.

Misappropriation or necessary contribution?

Andreu Segura

If we understand that health is not, as suggested by the Andrija Stampar definition adopted by the WHO in 1946, the mere absence of disease or insanity, but something else, whether it’s well-being as the aforementioned description affirms, it’s a reasonable ability to functional adaptation as René Dubos proposed, it’s easier to understand the importance of the so-called social determinants of health, among which health care is but one more.

These comments don’t imply any disregard for health care, given its ability to ease a good part of the disorders caused by diseases and, sometimes, to cure them definitively. Incidentally, insanity is, according to the dictionary, madness or mental disorder, a distinction that highlights the specificities of psychiatric pathology.

Defend

Salvador Casado

Everyone defends something, mainly their interest. In the healthcare world in which I work, this also happens and it is very common for these interests to clash between some professional categories against others or those who think in one way against those who think the opposite. In fact, this division has been one of the main reasons for the high levels of institutional mistreatment of health professionals in our environment.

But, beyond the purely statutory, I would like to ask the following question What do I defend as a public family doctor in a rural health centre? What do you defend from your position?