MMS President: Be the Voice of Patients on Both Sides of the Addiction Issue

With more than 1,000 overdose-related deaths last year, and the widespread suffering it has caused, the epidemic of opioid abuse in the Commonwealth has for the Massachusetts Medical Society become “issue number one this past year, and number one by a long shot,” MMS President Dennis M. Dimitri, MD, told his physician colleagues in his President’s Report to the House of Delegates at the Society’s 2015 Interim Meeting.

“What makes this public health crisis different from any other,” Dr. Dimitri said, “is that it cuts across many medical specialties and has engaged more non-medical stakeholders than any other public health issue in memory.”

Dr. Dimitri acknowledged the physician’s role in leading to the crisis.  “In our desire to control pain,” he said, “physicians unwittingly opened the door to this addiction epidemic.”

Yet he said physicians are faced with a difficult dilemma: how do we treat pain, and yet prevent addiction to the very medications that can ease pain?

“Physicians know that under-treated pain can be just as insidious as over-treated pain. We’ve embraced the concept that pain is the Fifth Vital Sign – that patients in pain are not well,” he said.

The opioid crisis presented the MMS with a challenge from state leaders to become partners in the effort to attack the crisis. The Society responded with a broad-based campaign of actions to address the crisis, including the development of prescribing guidelines, free offerings of pain management CME courses, discussions with medical school deans in coordinating pain management courses as part of the medical school curriculum and an educational campaign for the public and prescribers.

MMS leaders have also sought to improve the state’s prescription monitoring program and advocated for greater treatment and recovery programs. “Addiction is a medical issue,” he said.

The most difficult question, said Dr. Dimitri, is how success will be defined.  Changes in prescribing patterns, improved and expanded treatment services, and the reduction in overdose deaths are all intermediate goals and useful measures of success, he said, but he also issued a caution.

Physicians must never abandon patients who are in pain, said Dr. Dimitri. “We must have the wisdom to choose the right solutions, the perseverance to stay the course, and never forget those who suffer from pain, as well as those who endure the pain of addiction,” he said.  “We must be the voice of our patients on both sides of the issue.”

Read the full text of Dr. Dimitri’s Report here.

Erica Noonan

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