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Can we blame drug companies for physician over-prescribing? (no)


Dr. Gayani DeSilva MD


Addiction and Recovery

Gayani DeSilva is a Child Adolescent Psychiatrist with 20 years experience. She is the author of A Psychiatrists Guide: Helping Parents Reach Their Depressed Tween, and A Psychiatrists Guide: Stop Teen Addiction Before It Starts.

The opioid epidemic in the US has reached alarming levels.  The first trial holding a pharmaceutical manufacturer liable for misleading information about their opioid medication, and thus leading to overprescribing by physicians is set to begin.


I agree that the opioid problem needs to be addressed.  I agree that there is a pattern of over-prescribing of opioid pain medications.  I disagree with the statement that Physicians are being mislead by pharmaceutical companies and that is the reason for the over prescribing of opioids. This issue is far more complex than that!


I agree that using the word, “SAFE”, when describing an opiod is misleading, because there must be parameters placed on the use of any opioid.


All physicians know that opioids are addictive.


All physicians are trained to read scientific articles, and to get peer consultation (as needed) when making medical decisions--including the decision to prescribe any medication.


All physicians are aware that pharmaceutical companies market and advertise their medications, and give information about their product. But we do our own research and come to our own conclusions about the safety and efficacy of medications.  


Physicians are not the only people who prescribe medications. What is the data about the habits of non-physician prescribers who prescribe Opioids? How do they evaluate and make the decision to prescribe Opiods? This is something that I am not aware of, but plays an important role in addressing the Opioid epidemic.


The opioid epidemic is multifactorial--it is not merely the number of prescriptions a person gets that determines their risk of addiction and death.


Addiction to opioids is a family illness.  People can get opioids on the street. If other addictions exist, a person who starts opioid medications is more likely to get addicted to the opioid too.  


We need to start addressing the problems that give rise to the risk of addiction, the maintenance of addiction, and resolution of addiction.  We also need to look at what pain management truly means with the foresight that opioids are highly addictive and if used as the mainstay for pain management, will cause addiction to develop.


Pain management should entail psychological approaches, acupuncture or acupressure, exercise, meditation, non-addictive medications, and other techniques.  Opioids should be a very small, temporary part of the overall treatment plan.


The risk of death when using an addictive substance cannot be minimized.  People are more likely to commit suicide when under the influence of an addictive substance.  Ongoing use of opioids can cause depression and other mental illness.

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