Opioids: A Study in Lifelong Learning


By Dr. Henry L. Dorkin

It was only a few short years ago that the opioid crisis emerged across the country, with particular ferocity here in the Commonwealth. In retrospect, we realize the signs were clearly there. Unfortunately, many of them were missed.

Looking back, the role of the physician in this was clear. While our goals were laudable in trying to assuage our patients’ pain, some wrote too many prescriptions and, in those prescriptions, authorized too many pills.

This is not to cast blame. This is to focus on the problem and appreciate just how far we have come since the epidemic was first noted. The medical community quickly recognized that we had a more important role to play moving forward — as part of the solution. The Massachusetts Medical Society led the charge.

We have improved our prescribing practices. Data from the state show a 23% reduction in opioid prescriptions since 2015 and a nearly 50% reduction in prescribing to patients who had not previously received an opioid script.

We are working to improve patient access to life-saving care, from naloxone to medication-assisted treatment. Of course, we are looking to ensure that those in need of pain management are able to get the help they require.

Now, while law enforcement tackles the larger issue of non-prescription illicit narcotics, we physicians must continue to address the numerically smaller, yet no less critical, issue of overprescribing opioids for pain, and the diversion of medications. Progress has been made; more needs to be accomplished.

We all know the value of lifelong learning as physicians. This crisis, and our response to it, shows how quickly we can learn and how much we can change. May we continue to do so until this epidemic is over.

Henry L. Dorkin, MD, FAAP is president of the Massachusetts Medical Society. This article first appeared in the MMS publication Vital Signs.