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How Medical Authorities Contribute to the Opioid Crisis

“She was a caring, devoted, and motivated woman,” Bill Weeks said, describing his sister, Hailey. “And she died in a jail cell.”

People like Hailey Weeks do not fit the image that comes to mind when you imagine a drug addict and criminal: She was a successful lawyer with a triple major who enjoyed competitive horseback riding on the side. Yet in a surprising twist of fate, Hailey found herself in a jail cell with assault charges where she died four days later from intense withdrawal. Any stranger to her story would naturally jump to conclusions, but as the opioid crisis in the U.S continues to target a greater demographic than ever before, these judgment-ridden labels have become increasingly outdated and destructive to our hope of finding solutions.

I recently reached out to Weeks, a professor of psychiatry at Dartmouth College, to get his input on the opioid crisis. He offered insights not only as an economist and psychiatrist, but as a brother who has been personally affected. His sister Hailey wasn’t a delinquent drug addict. She was a passionate horseback rider who was prescribed medication following a riding injury. When her physician of 14 years discontinued his practice, Hailey found herself alone in a health care system where other doctors refused to treat her. Trying in vain to wean herself from the medication she had been legally and legitimately prescribed, she sought treatment for her addiction. During a withdrawal episode, Hailey kicked one of the nurses restraining her and was imprisoned.

The point of the story is not to blame Hailey, her doctor, or the nurses that treated her, but to understand the complexity of the issue. Hailey’s story and others like it demonstrate that even responsible, intelligent, hard-working members of society can fall victim to a series of unfortunate circumstances. When it comes to addressing the crisis, Weeks pointed out that unfortunately, “Instead of alignment, there is conflict. Instead of taking responsibility, clinicians may blame previous providers.” Patients in need are labeled as noncompliant drug addicts. “That labeling clouds our judgment and impairs the quality of the treatment we provide,” Weeks said.

I was particularly intrigued by one of the major disconnects within the health care system. Currently, there is no limit to the number of patients for which a doctor can prescribe medication. While the dosage of this medication is, in theory, carefully monitored by health care professionals, stories like Hailey’s demonstrate that there are too many cases slipping through the cracks and contributing to our nation’s current opioid crisis. Clearly patients have no trouble getting medication, but what happens when they seek clinical treatment for the subsequent drug dependence that develops as a result of irresponsible prescription practices? The answer is an overwhelming shortage of doctors available. Bill explains that most doctors blame patients’ previous providers and refuse responsibility for treating their mistakes. When physicians are willing to treat opioid-related addictions, they are limited to treat a maximum of 275 patients per year even after extensive certification.  

It seems the system is setting itself up for failure. The problem is perpetuated because prescribing more medication is not only easier, but even encouraged from a financial standpoint. Why would a doctor choose to go through the time-consuming, expensive process of treating long-term patients when he can simply cycle through patients quickly—and without limit—by writing them off with a prescription?

Even here at Boston College, we need to stop labeling and begin to understand the humanity behind this issue. It is not until the entire public understands the complexities of the circumstances from which addictions arise that we can begin to approach solutions and treatment with a sense of compassion. In addition to educating people about the problem growing right before us, Weeks suggests that medical authorities lift the 275-person cap on the number of patients physicians are able to treat, while implementing stricter controls on the number and dosage of opioids prescribed in order to address system disconnects.

For Weeks, the crisis that claimed his sister’s life is not only a medical problem, but a moral one.

“I could make more money by prescribing painkillers to 5,000 patients, but if we want to get to the root of the issue we need to begin treating them,” he said. “Too often physicians administer irresponsible dosages, then abandon their patients when they become addicted. We as physicians are responsible to change this.”

Featured Graphic by Nicole Chan / Graphics Editor

February 28, 2018