Doctors seen as cause, solution to crisis


Doug Oplinger - Guest columnist



There was a paragraph in an Akron Beacon Journal story last fall that raised tough questions about the medical industry. The story was about a local hospital successfully managing pain following surgery by prescribing medications other than addictive opioid painkillers.

The paragraph said this of the non-opioid experiment: “The patients were easy to convince. It was tough to convince the other surgeons, anesthesiologists and nurses because it challenged their typical teachings.”

Opioids are those drugs killing 4,000 Ohioans a year, and a study by the state showed that 80 percent of those who died of an overdose were at one time prescribed an opioid medication.

The medical community needs to acknowledge that people are terrified. There is a fear of waking from surgery with a chemical dripping into their veins that has the potential for altering their brains.

And for those in the grips of addiction, they fear dying of an overdose, or of not getting the next dose.

Yet, a retired pastor friend recalled a recent emergency room visit in which an opioid was handed to him for a fractured bone. He declined the medicine and asked for something different. He still was charged for the opioid because it was already dispensed – it’s that much a part of the culture.

In the last five months, the Your Voice Ohio project held eight community meetings in the state’s hardest hit communities – Dayton, Middletown, Cincinnati, Youngstown, Warren and rural southwest Ohio (including in Wilmington and in Washington Court House).

What became clear was a dramatic divide between the terror and desperation in families struggling with opioids and a variety of players who have a role in the crisis – public officials and, in particular, the medical industry.

Heard over and over in the community meetings was this idea: Every person can gain from participating in conversation with all the stakeholders and thinking about a small role he or she can play in order to make a difference.

And meeting participants took note: Doctors and hospitals writing prescriptions for opioids were largely missing from the conversations.

Out of eight community meetings organized by the media collaborative and attended by more than 300 people, four medical doctors voluntarily showed up – one a psychiatrist wondering how to treat those with addiction and the three others in the business of managing opioid recovery. There were no hospitals or doctors in the business of prescribing.

One person asked at a Youngstown-Warren area meeting, “Can the medical community become more involved?”

That’s not to say the industry isn’t working on alternatives. The Akron hospital initiative is one of many experiments in Ohio, West Virginia and Kentucky – the epicenter of the crisis.

But the people in those meetings don’t know that, and if anything, this illustrated the disconnect between the people and institutions.

Large institutions have people working on change, for sure. But the fact that they do allows all the others in the organization to go about their routines with the false comfort that this problem is someone else’s.

At those sessions, families, people in recovery, local officials, local volunteers and journalists discussed sometimes in intimate, tearful stories the suffering wrought by this drug that is cheap and easy to find on the street. After every meeting, almost everyone raised a hand when asked if they learned something new, if they met someone different and if they felt the conversation was productive.

Many left wanting to take action in a personal way.

Perhaps doctors are too busy to voluntarily attend those meetings. Perhaps they think Ohio is too many years into the opioid crisis to think more public engagement would make a difference.

But this is a deadly crisis unlike any faced before. The medical industry created and administered a drug that can alter the brain resulting in mental illness and drug dependency. It’s now part of the illegal drug trade.

For the medical industry, this is a public relations problem that isn’t about messaging. It’s about, well, public relationships.

Doctors and pharmacists have been a topic of discussion at all meetings. In Dayton, the question was raised: With so many hospitals, is that the reason this area is the worst in the state for opioid addiction?

That’s not a good theory to have in your community – that hospitals are working against the people.

Washington Post and CBS News reports on the pharmaceutical industry lobbying Congress to win weaker regulation of opioid trade haven’t been lost on the public. One person in Dayton referred to the laxity as “government-funded genocide.”

A presentation last fall at Ohio State by a medical ethicist accused the media of misrepresenting the facts. He said doctors followed acute-pain protocol: Certain levels of pain required treatment. He said the medical community has no culpability — doctors were just doing their jobs.

But if you listen to the community conversations, others were just doing their jobs, too. Construction workers and coal miners who were hurt went to the doctor, received a prescription for an addictive drug and unwittingly followed the instructions on the bottle. A few pills and they were hooked. Culpability?

Doctors will be well served to express themselves as real people: How they’ve been played by patients; the experiments they’ve tried to wean victims from drugs; the state’s arbitrary limits on how much can be prescribed.

The Your Voice Ohio project is a collaborative of more than 30 news outlets in Ohio, working together to provide more comprehensive stories representing the issues facing the people of the state. The goal is to represent the diverse voices of the people, to show communities working to solve problems and serve our role as an integral part of democracy.

Polls show Americans blame journalists for the divisiveness and dysfunction of the country. Part of the mission of the Your Voice Ohio project is to help journalists see themselves as part of the community – of having ownership of problems and solutions.

In listening to the conversations about opioids, it sounds as though people are holding the medical community accountable for this deadly crisis and its resolution.

Does the medical community want to leave it at that?

Doug Oplinger is retired managing editor of the Akron Beacon Journal, where he worked for 46 years. He now directs the Your Voice Ohio media collaborative. He can be emailed at doplinger@yourvoiceohio.org.

Doug Oplinger

Guest columnist