By Ray Tuck, Dianne Rowell, Harrison Hunt, and A.J. LaBarbera
Tuck of Tuck Chiropractic is a member of the Virginia Board of Medicine and the immediate past President of the American Chiropractic Association. Rowell is a family medicine specialist in Bedford and has been practicing for 30 years. Hunt is a physical therapist with Rehab Associates based in Central Virginia. LaBarbera is a chiropractor that is a board member of the Virginia Chiropractic Association and is currently active in practice in both Bedford and Roanoke.
Opioid addiction continues to make headlines here in the Roanoke and New River valleys and across the country. Every day, lives are lost and families are shattered because of an addiction to painkillers — maybe even someone close to you is affected.
On average, more than 40 people die in the United State every day from unintentional overdoses from prescription opioids. In Virginia, a t least 1,420 people died last year of drug overdoses, the fourth year that drugs have outpaced motor vehicle accidents and gun-related incidents as the leading cause of unnatural death in the state.
Fatal drug overdoses increased 38 percent in Virginia between 2015 and 2016, according to the state Health Department, an alarming jump that state health officials attribute to abuse of synthetic opioids, heroin and prescription fentanyl — a pain medication significantly more potent than morphine. Even for those who died of a heroin overdose, their addiction often began with a legitimate prescription for pain.
This has a devastating impact on families, communities and the economy. But i t doesn’t have to be that way.
With medical professionals of different disciplines working collaboratively and with patients who suffer from pain taking a longer-term view to pain management, there are plenty of safe alternatives to potentially addictive and harmful opioids.
These include non-opioid prescriptions, physical therapy, chiropractic care, homeopathic remedies, nutritional supplements, whole foods — even exercise and stress-management classes.
In this smartphone-armed, interconnected world we are used to instant gratification and quick solutions to everything. Need to buy an item online for delivery next day? No problem. Need instant feedback on which restaurant has the best pizza? Give it 30 seconds. But your body is not a consumer product and everyone heals differently. There should be no such thing as instant relief to systemic pain.
Adopting a go-slow philosophy should be the first step in protecting yourself and loved ones from potentially addictive drugs.
It’s also time for medical professionals of all disciplines to band together to end this unnecessary suffering and provide viable and safe options to manage pain. The co-authors of this article feel strongly that better collaboration among traditional and non-traditional medical experts can help people manage pain and improve outcomes without having to take drugs that are creating a public-health epidemic in our region and around the country.
It’s tragically ironic that prescription opioid overdose deaths have increased dramatically at a time when we have all the data we need to effectively target at-risk patients and address their personal risk factors with customized medical solutions.
In response to the escalating opioid crisis in Virginia — now part of state law — the Board of Medicine (of which co-author Dr. Tuck is a member) worked with the Virginia legislators to create regulations on the prescribing of opioids for pain. We agree with these guidelines for medical professionals:
• Non-pharmacologic therapy, non-opioid treatment should be considered prior to opioid.
• Provide clear, evidence-based guidance on the proper prescribing for acute and chronic pain.
• Decrease the number of patients who abuse or develop an addiction to opioids.
• Rein in intentional and indiscriminate over-prescribing by practitioners who treat pain.
The Board worked diligently with pain experts, addiction experts and stakeholders to develop these regulations that will not hinder the good practice of medicine but will prevent the diversion of opioids for non-medicinal use.
These regulations make sure that the needs of patients currently receiving opioids for chronic pain are taken into account. It is critically important that no patients in Virginia find themselves looking for narcotics outside of the medical system — on the street, for example.
Patients need to know that physicians in Virginia must:
• Provide treatment with opioids for acute pain with short-acting opioids, and for a seven-day supply or less unless extenuating circumstances are clearly documented in the medical record.
• Treatment with opioids as part of treatment for a surgical procedure must be for a 14-day supply or less unless extenuating circumstances are clearly documented in the medical record.
• An appropriate medical history and examination must be performed in accordance with state law.
• The practitioner must discuss risks, benefits, proper storage and disposal with the patient.
For those who are affected by pain and opioid addiction — and the children and families in the wake of this national travesty — there is hope. We encourage you to educate yourself about physician regulations and consider proven, trusted and safe alternatives to popping pills.
You are the first line of defense in your own healthcare. Ask the right questions. Be open to alternative solutions. And remember that pain management is a journey, not a quick fix.
Thank you for being an educated healthcare consumer as we work together to end the opioid crisis.