Thomas Schaaf: Washington physicians aggressively working for solutions to opioid crisis

Rarely a day goes by without news reports on the impact of opioids on individuals, families and communities. The Spokesman-Review’s article published Sunday, Feb. 4, “Washington nurses, health care workers are dying of opioid overdoses,” shows that health care providers are not immune – even though we know the dangers and we see firsthand how it affects our patients and their families.

For physicians, the misuse and abuse of opioids is especially sobering. In too many instances, abuse stems from prescribed opioids, as the powerful addictive qualities can lead to opioid use disorder (addiction) and overdose.

We are trained and committed to provide compassionate medical care to our patients, and we are alarmed that these medications – prescribed precisely because of their ability to relieve a patient’s pain – have now become the cause of so much suffering.

Physicians are responding. Since 2008, with the introduction of the nation’s first state-based guidelines for prescribing, we have actively and aggressively worked to address prescription opioid abuse and overdose. Those efforts have made a difference – Washington has seen a 44 percent decline in the number of unintentional prescription opioid deaths since the guidelines were introduced.

Our work makes us a leader among states seeking to mitigate the role prescribing has had in the epidemic. While this work may not be grabbing headlines, it does represent the day-to-day caring and perseverance required to reduce the abuse of prescription opioids and resulting impact on our patients and communities.

The Washington State Medical Association is aggressively pursuing new efforts to reduce the role of prescribing in the epidemic, including helping to pass House Bill 1427 in 2017. This legislation makes it easier for physicians to access data from the state’s prescription monitoring program to inform their prescribing and requires the state to develop safer opioid prescribing rules for all prescribing professions.

The WSMA is partnering with state agencies, medical organizations (such as the Washington State Hospital Association) and communities to introduce targeted strategies, including stronger prescribing guidelines for providers serving Medicaid patients and state employees. These initiatives focus on eliminating inappropriate prescribing while ensuring that patients with legitimate pain needs are able to access appropriate treatments.

These efforts seek to build upon our state’s success at reducing prescription-related deaths. However, that success is greatly tempered by the fact that overdose death and injury from illicit drugs – including heroin – has increased dramatically over the past decade. Acknowledging this fact is crucial to inform where greater attention and resources are needed.

To that end, the WSMA is grateful to see Gov. Jay Inslee propose legislation that includes critical investments in addiction treatment, recognizes addiction as a treatable medical condition and seeks to make access to addiction treatment available for every Washingtonian who needs it. The WSMA urges state lawmakers to support these bills and the crucial investments they make in treatment capacity.

These investments will make it possible for us to effectively treat our patients who are suffering from the disease of addiction, ensuring treatment is available when a patient not only needs help, but also is ready for that help. That, together with clinician-informed safe prescribing efforts, would ensure that Washington has a comprehensive approach to combating the opioid epidemic.

It is our belief that together, physicians and patients can come to better understand the promise – and perils – of these powerful substances, as well as the importance of having non-opioid treatments available. Working together, we can treat pain with greater awareness, compassion and responsibility: cautiously yet effectively, safely and without fear.

Thomas Schaaf, M.D., is a Spokane-based family medicine physician affiliated with Providence Medical Group and Chief Medical Officer at Providence Senior and Community Services in Tukwila. He is president-elect of the Washington State Medical Association and serves on the association’s Joint Opioid Safe Practices Task Force.