Last week, the US surgeon general sent me a letter. In fact, Dr. Vivek Murthy sent a letter to every one of the more than 900,000 doctors in the United States, asking us to help end the opioid overdose epidemic that now kills more people each year than traffic accidents. His call for us to commit to "turn the tide" on the epidemic hit home for me, both as a physician and as CEO of the California Health Care Foundation, where we are supporting a multipronged effort to fight opioid addiction in our state of 40 million people.
"We arrived at this place on a path paved with good intentions," writes Dr. Murthy. I can attest to this, as can my colleague at CHCF, the architect of our opioid safety work, Kelly Pfeifer, MD.
For decades, we clinicians took mandatory classes informing us about the need to regularly assess patients for pain and imploring us not to undertreat pain. Today we know so much more about the biologic processes that cause pain. We also know a great deal more about the neurobiology of addiction and the impact of high-dose, long-term opioid use on the brain's ability to manage stress, pain, and daily functions. As physicians, we want to help patients suffering from chronic pain. But while the promise of long-term benefit from these opioids rarely materialized, addiction and other opioid-related medical problems often did.