It is Time to Move Past Maslow's Hammer in Pain Management
Abraham Maslow first published the famous proverb “if all you have is a hammer, then everything looks like a nail,” in 1966 in The Psychology of…
This Article originally appeared in the Washington Post and was subsequently picked up by the Lincoln Nebraska Journal Star
33,000 people died from opioid overdose in 2015 according to the Centers for Disease Control and Prevention. Some of these deaths are due to heroin, but many are from legal painkillers prescribed by licensed practitioners.
The Washington Post reported this week that as an attempt to curb the epidemic of opioid addiction that is claiming tens of thousands of lives each year, Seattle officials last week approved the nation’s first “safe-injection” sites for users of heroin and other drugs. The move has been described as drastic but necessary to “bend this curve of death because [safe-injection sites] are going to have to be part of the strategy,” said Jessie Gaeta, chief medical officer of the Boston Health Care for the Homeless Program, which treats many victims of overdose.
Medical supervision, clean needles, and access to drugs that reverse the effects of an opioid overdose are offered at the sites which have been popular in Europe. With opioids now killing more people per year than guns or car crashes, the idea is gaining momentum in a number of American cities, including New York, Boston, and Ithaca, NY.
While supporters claim they can keep people alive and direct them toward treatment for their addiction, opponents say the sites promote illegal drug use. The sites are not currently legal under federal law according to Kelly Dineen, a professor of health law at Saint Louis University School of Law.
by: Phillip E. Essay, MD
The report of Seattle’s approval of the “safe-injection” sites made by Katie Zezima of The Washington Post uncovered many important facts regarding the devastation caused by opioids but failed to mention the $78.5 billion dollar estimated economic burden to Americans reported in the October issue of Medical Care. In addition, the Post article misleadingly implied that most if not all addicts are homeless, as both Seattle sites will be aimed primarily at homeless drug users to provide them basic health services and ultimately drug treatment.
This implication is particularly detrimental to developing effective, proactive solutions to fix the problem instead of controversial reactive ones. In fact, 70% of the estimated 15 million Americans who use illegal drugs or who use legal drugs, illegally are employed. The stereotype of the opioid abuser starting out as homeless is incorrect. Opioid abusers wear suits and ties, live in middle class homes, and work next to us every day.
Opioid abusers attend our schools and our churches. They work in our American businesses and factories. In 2009, 12% of full-time employees reported current use of an illicit drug or a prescription drug used illegally. It is a critical distinction because until we can begin to see the opioid abuser for who they are, we can never begin to “bend this curve of death.”
The way to begin to curb this deadly and costly epidemic of opioid abuse is for American businesses, and schools, and churches, and families to become informed about the current evidence on opioids and their impact on all of us. We must all participate to create a “call to action” for our workplaces, our churches, or our schools. We must empower our leaders to discuss opioid concerns openly. We need to develop programs to include clear written policies as a critical element to success. We must engage as a society to minimize the serious risk and cost that opioids inflict on all of us.
Information is power, and alternatives to opioids are available for the treatment of chronic pain. Through education, programming, and sound policy we can provide safer environments for employees and customers, reduce insurance premiums and claims, reduce lost work productivity, and provide assistance to avoid and recover from opioid abuse / misuse.