Facing the opioid epidemic, doctors struggle to find solutions

(KMSP) - One of the toughest fights in America right now, the opioid crisis, is far from over.

And now, nominee Tom Marino has withdrawn his name from consideration as the next drug czar after reports that a measure he championed hurt the Drug Enforcement Administration in its fight against opioids and pumped more painkillers into areas already vulnerable to a burgeoning crisis.

Further reports this week from CBS News and the Washington Post revealed the business interests that have helped fuel America's opioid epidemic.

Now, a local doctor says the system that created the problem remains very much intact.

"The mal-aligned incentives in health care persist," said Chris Johnson, an ER doctor and advocate.

Johnson knows the problem all too well, including the incentives aimed at driving business--coming oftentimes at the expense of patient care. And in the case of America's opioid epidemic, it's that focus on business he believes still persists.

“We've been generating very handsome revenues for the medical industry and look what happened: We have over 200,000 dead in the last 15 years," he said. "Other countries didn't do this; the opiate epidemic didn't happen in Britain."

Johnson points to a pharmaceutical industry intent on shaping law.

The CBS News-Washington Post report outlined how 2016 legislation made opioid manufacturers and distributors almost untouchable, while at the same time doctors felt top-down pressure--resulting in more prescriptions.

"The ongoing metric that doctors face is one of a business metric: How efficiently are you generating money for your clinic?" Johnson said.

Johnson said reliable science and data surrounding opioids has been long overlooked, and in recent years a focus on opioid education is creating a distraction.

The real solution, he says, is less about a pill than the system that embraces it.

"Lack of education is not why things happen,” Johnson said. “An agenda is why things happen. So we were incentivized to expose more of the population, to write more prescriptions."

In the end, he believes, it's important for anyone who goes into a doctor’s office to think very carefully about opioids, should they be prescribed.

In many cases there are alternatives with dramatically lower risk of dependence.