The June 3 front-page article “Unintended consequences” addressed health-care professionals’ increased reluctance to prescribe opioids because of the recent crisis. The article relayed the story of Kenyon Stewart, a man who must drive 367 miles each month to receive his opioid prescription to treat pain from his injured hip. While this article highlighted some of the adverse effects of the recent opioid crisis, it is important to understand the dangers of opioids to adequately and efficiently solve the problem.
Even for patients who need the medications to treat pain, opioids can be quite dangerous, requiring doctors to be careful when prescribing. The National Institute on Drug Abuse says that 8 percent to 12 percent of patients prescribed opioids for chronic pain develop opioid disorders, and 4 percent to 6 percent who misuse prescription opioids transition to heroin. Many overlook that both sides of the problem, underprescribing and overprescribing, can be limited by closer relations between patients and health-care providers. If both parties understand that there is a mutual goal to treat pain effectively, both will be more encouraged to work together to help the patient. This, in turn, allows health-care providers to understand patients’ unique situations, helping patients receive treatment without risking addiction.
James Frucht, Vienna
Kenyon Stewart had a commercial driver’s license and drove a truck for “years” while on a pain medicine cocktail that eventually reached six times the Centers for Disease Control and Prevention’s recommended ceiling. No explanation was given as to how Mr. Stewart maintained his commercial driver’s license while on opioids, given drug testing in the industry. The article did, however, go into harrowing detail of Mr. Stewart’s road trip to the pain clinic. Specifically, how he contemplates finding a gas station to stop and have a beer. His pill supply dwindling and leg starting to hurt, he apparently reasons, “a little alcohol helps.”
Unfortunately, “the race to end the opioid crisis” is also creating pain for people who share the roads with these reckless and dangerous drivers.
Lynn Rice, Purcellville
Kenyon Stewart’s sad story of pain, lost employment and desperation is tragic. I am a nurse practitioner. I’ve had patients with serious injuries who, after other measures failed, are on controlled substances so they can go to work and support their families. They should be treated as a whole person, just as any other patient would be.
By getting on controlled-substance contracts and setting up a monitoring and support system, patients are not dying but living productive lives. Yes, they may become addicted to their medications, and this is explained upfront. Drug-seeking patients are dealt with per Centers for Disease Control and Prevention guidelines.
At this time, the opioid crisis has created a class of victims who, as does Mr. Stewart, live in pain and fear that the only option is suicide. Pharmacies are now arbitrarily denying legitimate prescriptions that follow CDC guidelines. The pharmacist does not have the patient history but denies the script, creating more anxiety for fragile patients. We must put in place a rational, compassionate, caring and comprehensive approach to treating pain patients, and it must include primary care providers.
Susan Delean-Botkin, Oxford, Md.