More than a pledge needed to solve opioid epidemic, physicians say


Even if doctors do as the U.S. Surgeon General suggests and sign an online pledge, it won’t solve the opioid epidemic. What’s really needed is effective treatment for people addicted to painkillers and other drugs, according to a number of physicians. "Does any prudent physician think that a ‘pledge’ is going to fix this problem?” asked Howard C. Mandel, M.D., an obstetrician/gynecologist in Los Angeles.

Last week, the country’s 2.3 million physicians got a letter from U.S. Surgeon General Vivek Murthy, M.D., asking them for help to reverse the opioid crisis and urging them to take an online pledge to educate themselves to treat pain safely and effectively, screen patients for opioid use disorder and get them into treatment, and treat addiction “as a chronic illness, not a moral failing.”

While the surgeon general’s letter was well-intentioned, physicians told Medical Economics that they don't think it would make a big difference in the opioid crisis.


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“I have known Dr. Murthy for many years. He is a well-meaning, smart and caring man. Unfortunately, academics and public policy-oriented physicians like himself have no clue how to deal with this problem. Does any prudent physician think that a ‘pledge’ is going to fix this problem?” Howard C. Mandel, M.D., an obstetrician/gynecologist in Los Angeles, told the publication.

Mandel and others said the country must instead fund effective treatment and research prevention. “Finding evidence-based treatment after diagnosing the problem is next to impossible for the patients we see,” said M.G. Garett-Shaver, M.D., residency director for a family medicine rural training program at the University of Arkansas in Magnolia. And Dan Logan, a family physician in Dayton, Tennessee, said more physicians must step up to treat opioid dependency rather than leaving it up to addiction specialists.

Not everyone, however, was skeptical the letter would help. Sachin Parekh, M.D., who practices family medicine in Hartford, Connecticut, called it a “very effective strategy” that can help doctors prevent overprescribing of opioids and consider other alternatives to treat pain.

As doctors have reacted to the Centers for Disease Control and Prevention’s opioid prescribing guidelines by cutting down or not prescribing opioids for patients’ pain, some physicians worried the inadvertent result has been a spike in heroin use.