Opinion

Solving the opioid crisis means dealing with people

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After “finding a public policy problem, invite to the table experienced people with all points of view, truly listen to each other, and find a solution. In the process, always remember we’re dealing with people. It’s not enough to simply change public policy. We have to make sure we have help for the people the policy change leaves behind. That’s the philosophy of the symposium,” said Kandyce Powell, RN.

We are talking about society’s opioid crisis, and about the focus and desired outcome of the “21st Annual Pain Symposium: Treating Pain Amidst the Opioid Crisis,” May 4, at Thomas College, Waterville. Powell is executive director of the symposium’s lead group, The Maine Hospice Council and Center for End-of-Life Care. The symposium is also supported by Maine Health Care Association, Maine Medical Association, and New England Cancer Specialists.

Public policies play a key role in the opioid crisis getting better or worse. So all 2018 candidates for Maine governor are invited to take part in the symposium. First, said Powell, “to listen to a thoughtful, comprehensive discussion from experienced, thoughtful, and articulate people very concerned about this issue.”

Maine’s gubernatorial candidates are also invited to share topical questions-and-answers with a moderator and audience members.

“I’d like for [candidates] to listen to what [government] rule changes, policies, are doing to disenfranchise, even more, some segments of our society,” Powell said. “If just we could get back to dialogue. To say, ‘Okay. if we do this [policy], what are the pros and cons? That would really be a goal of mine,” she said.

For example, news stories this week cited decreases in opioid prescriptions. A New York Times report said the decrease, “reflects a stepping up of efforts among policymakers and the medical establishment to address the nation’s opioid epidemic, …killing more than 115 people every day.” The Portland Press Herald reports Maine had 418 drug overdose deaths last year.

The prescription decrease is “good,” said Powell, a registered nurse. “But what about the people impacted by that decision? Are we offering them help? Or are we okay with them as collateral damage? This opioid crisis is fueled by so many social determinants. It’s not just physicians and others writing prescriptions,” she said.

Powell continued, “Writing prescriptions for opioids is totally appropriate in appropriate situations. The important piece [in] prescribing opioids is to do a thorough, careful assessment, document, follow up, revise the plan of care, change medication if you need to. But make sure you have standards for prescribing based in reality. With public health issues you really have to invest time, and people, and societies, and communities to find out what’s wrong,” she said.

“How can you put a thoughtful strategy together, that has any chance of working, if you don’t really get at the heart of the people involved in this?” asked Powell.

She gives one example: A young lady sexually abused for years at home. In daytime, school is her escape. At night she returns home. “Wracked with existential guilt” she “goes to the doctor” with pain symptoms for a ten-minute visit.

That’s not enough time.

Back in school a friend says to the young lady, “Try this. This will make you feel better.” That escape is “the only thing that’s really given her any relief and she becomes dependent on that,” said Powell.

“If nobody gets at the root of her social determinant, her daily family life contributing to this…. You mean to tell me that’s not valuable [information]?” she said.

The opioid crisis “is about all of us,” said Powell. “It is about the health of our society. We need everybody’s voice at the table, and we are interested in listening to everybody.”

For symposium details: https://bit.ly/2vykusF

Scott K. Fish has served as a communications staffer for Maine Senate and House Republican caucuses, and was communications director for Senate President Kevin Raye. He founded and edited AsMaineGoes.com and served as director of communications/public relations for Maine’s Department of Corrections until 2015. He is now using his communications skills to serve clients in the private sector.

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