The Opioid Crisis and the Way Forward

This is part 4 in our series on the opioid crisis, presented with support from the NIHCM Foundation.

We've talked about the state of the opioid crisis, deaths of despair, and the disappointing evidence about marijuana as a treatment for opioid dependence. But the outlook doesn't have to be entirely bleak. There are concrete policy changes we could make that might help stem the crisis. One of the most prominent is the use of MAT, or medication assisted treatment.

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Credits:
Aaron Carroll -- Writer
Meredith Danko – Social Media
Tiffany Doherty -- Writer and Script Editor
John Green -- Executive Producer
Stan Muller -- Director, Producer
Mark Olsen – Art Director, Producer

Images and Footage
Videoblocks/TheSceneLab
Videoblocks/made360
Videoblocks/emiryorda
Videoblocks/barselona_dreams

#healthcaretriage #opioids #addiction

[iquemedia]

2:08 bro i worked in a *retail* pharmacy for 2 years and we gave out percs like they were candy but when someone needed their suboxone it felt like penetrating the great wall of china to get the insurance to pay for it

[mattwodziak]

Dr. Carroll, I think this was your best HCT episode to date. Thank you!

[ilikedota]

@4:57, that does confirm what I thought. There are a lot of simple things that collectively have a huge impact, Nalaxone, medication to treat addiction, reformulating drugs to be harder to abuse, drug take back, pyschosocial treatment (reducing it to a moral failing or to chemistry alone isn't correct), and clean needles. They all seem obvious to me. Good to see evidence.

[unappropadope]

God I love healthcare triage. I feel it’s the crown jewel of complexly; thank you for this series!

[SexyDalton]

Can we get an episode on how to get policy makers to change stigmatic stances on abuse disorders and what has worked? Obviously there are insidious motives for keeping people addicted to opioids. As an ER nurse if Fort Wayne, I would love to do more than Narcan somebody and send them home when stable without a road to recovery. Thanks for all the work you do HCT!

[deborahvidal]

I tested positive for opioids taking naltrexone prescribed by my psychiatrist!

[BTheBlindRef]

Doing everything and reducing the impact by 11% is NOT a lot. It is a shockingly small number given how many programs and changes that estimated reduction incorporates. I agree we have to start somewhere, but we better be able to do WAY better than a 10% reduction. That's pretty pathetic.

[paineoftheworld]

In the United States at least, the suffering is the point. You mention stigma and I would like to point out that this stigma is manufactured in little shops found throughout the nation usually on the corner of Main and Elm with a pointy roof. It goes beyond that even because the intersection of profit with these fabricators brings a horrible, merciless calculus to our culture that even as we tout individualism, we are more than willing to jettison one if they don't fit the desired mould. Since the foundation of the colonies, this is the way it has been. The inertia to be overcome in order for change to happen is massive and deeply seated.

I applaud your efforts, Doctor, in chipping away at it.

[paxundpeace]

Please do some crossover with for example Medlife Crisis or other medical youtuber

[kitthornton]

What does a successful MAT program look like? As a prosecutor, it seems like every other impaired driver who hurts someone tests positive for Suboxone and other "addiction treatment" drugs. The best place in town to buy hard drugs is the parking lot of the Methadone clinic. I'm not doubting that addiction is a medical problem, at least in part, but what would an EFFECTIVE program look like?

[sneakerbabeful]

We can't do anything. Because people aren't willing to change systems leading to despair.

[chanvalentine]

Thanks YouTube algorithm. I didn't ask for this video. My 2 cents. 7 doctors didn't listen when I told them it was severe inflammation. Dr 8 gave me arthritis meds, diagnosed me with lipolymphadema, and reduced enough of the pain so i could sleep.

[wozbrown]

Quite a few years ago there was a BBC lunchtime news feature on a trial to cure chemical addiction. It was reported to be +90% effective in the trials so far.
It worked by measuring the frequency of the drug and then passing electrical current of the same frequency through 2 electrodes the patient held in their hands.
This caused the body to quickly start to excrete the substance out through the skins pores.The clinic room even had an en-suite shower to wash it all off. I forgot all about it for years and now can find no mention of it on the net.I wish I had recorded it but I had missed the very start of the feature and thought I’ll just record the evening news and get the whole thing. It wasn’t on the evening news however.

[robinsss]

we need to create safe injection sites
they reduce od deaths

we need studies on delta 8 and 9 in treatment of opioid withdrawal symptoms

[italktoomuch]

"We need more nets!"

That's my new battle cry.

[bryce]

We need pain medicine that is more selective and doesn’t activate the opioid receptors that cause the high and addiction. Until those drugs are finished with their development we won’t see much progress with the opioid epidemic. Even then those drugs will be brand name and more than likely very expense, which will be a problem in promoting wide spread use.

[eltonej]

Why save the life of a drug addict? That belief is why it's easier for doctors to prescribe the cause of addiction but not the treatment. That is the cause and lifeblood of stigma.

[RealUlrichLeland]

It's crazy thought that even if all those approaches were out in place you would still have around opioid deaths per decade. Perhaps though, if the right tools were put in place the next generation would benefit substantially more from them. Fewer parents on opioids means reduced exposure for their children to them, and perhaps the stigma and reluctance to treat the problem as a disease will also take a generation to change.

[ThreeRunHomer]

The answer to all of your questions is money. Making and prescribing ultra-addictive drugs is highly profitable for drug companies and doctors. They are the new drug pushers, under a thin veil of respectability. 💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰💰

[dailydoseofmedicinee]

Most common side effects are predictable consequences of opioid pharmacological actions and include nausea, vomiting, constipation, pruritus, dizziness, dry mouth and sedation. Side effects are extremely common with opioid therapy👍