For every athlete, recreational or professional, young or old, injury is probably going to sideline them at some point in their career. Edward McDevitt, MD, an orthopedic surgeon with Bay Area Orthopaedics & Sports Medicine, sees many of these athletes and knows that getting them back in the game is important. But so is treating their pain responsibly.
In the past two decades, opioid addiction rates have soared across the nation. In Anne Arundel County, 308 heroin and opioid overdoses were reported last year. And prescription opioid abuse is often a first step to heroin addiction.
That’s because when a person can’t get enough pain medications from a doctor to satisfy their need, they often turn to the street. “And once you start buying those narcotics on the street, you realize how expensive they are,” says Dr. McDevitt. “Then it’s very easy to switch to heroin, because it’s 10 times more euphoria-producing and 10 times cheaper than oxycodone.”
The PCP’s Role in Prevention
According to Dr. McDevitt, primary care doctors play an integral role in preventing this cycle from starting. “We as physicians have to realize our part in it as the first person who’s giving people what we think are legitimate narcotics,” he says.
His first piece of advice for treating injury-related pain: “Don’t think of narcotics first.” Dr. McDevitt often prescribes anti-inflammatory medication, directs patients to apply topical pain relievers, and refers them to physical therapy. He also encourages people to consider alternative therapies, like chiropractic care and acupuncture.
But if a patient’s pain level merits opioid painkillers, start by prescribing a small number and tell the patient to request more if needed. Most people don’t finish a 30- or 60-pill prescription, and leftover narcotics stored in a medicine cabinet are at high risk of being abused by family members or acquaintances.
Once you’ve started prescribing narcotics, keep in mind that after a while, you have to stop. “A lot of times an athlete says, ‘I’ve got a big game, I need a little extra,’” says Dr. McDevitt. “You fall into the trap of helping the athlete who’s not really taking it because they’re in pain.”
Don’t Be Fooled
Educating yourself will help you avoid traps laid by drug seekers. There are CME courses on safe opioid prescribing, and Dr. McDevitt says it’s also worthwhile to type “scam doctor for narcotics” in Google. “The statements I found are things I’ve heard in the last three months from my patients,” says Dr. McDevitt.
“I know that I’m imperfect too, because I’ve been fooled,” admits Dr. McDevitt. But he strongly believes that becoming aware of the opioid addiction problem and the role physicians play can make a difference in the current crisis. “I wish doctors realized how important they are in the process,” he says.