By Jacki Wood, written for the Nodaway News Leader, March 2016

Editor’s note: this is the third part in the series; the names have been changed to protect their privacy.

An estimated 1.9 million people abused or were addicted to prescription opioid pain medication in 2014.

Those findings from SAMHSA were highlighted March 15 when the CDC released new guidelines aimed to reduce the risk of opioid addiction.

The voluntary guidelines are based on emerging evidence for patients with chronic pain not related to cancer treatment, palliative or end-of-life care.

Among the recommendations are that doctors try pain relievers like ibuprofen before prescribing highly addictive painkillers such as hydrocodone and oxycodone.

Other recommendations include non-prescription treatments such as exercise therapy, tai chi, yoga, weight loss, psychological therapies, interventions to improve sleep and certain procedures.

“It has become increasingly clear that opioids carry substantial risk but only uncertain benefits,” Dr. Thomas R. Frieden, CDC director, said, “especially compared with other treatments for chronic pain.”

***

As Adrianna’s mom became more addicted to the pain meds prescribed by her doctors for her chronic illness, the worse things got at home.

She began seeing problems in her parents’ marriage and her mom finally moved out which surprisingly was a relief for Adrianna.

Her mom had been texting hateful, degrading messages and posting belittling statuses on social media about her. She eventually had to block her phone number and report and block her on social media sites.

“I wanted her out of my life,” she said. “It wasn’t my mom; it was a monster in my mom’s body.”

***

Pat Giffin, RN and emergency department nurse manager at SSM Health St. Francis Hospital, said people don’t intend to become addicted to opioids, they just want something to take away their pain.

“Opioid addiction can make people do things they never would have thought of doing before the addiction, just to get more of the drug,” she said.

The hospital is currently working with SSM Health’s legal department to develop a notice for the emergency department stating that the hospital will not prescribe narcotics unless there is an acute reason.

“Prescribing opioids to patients who do not need them for acute pain only results in addiction and more problems for the patient,” Giffin said. “Chronic pain issues need to be handled by one physician so that the usage can be monitored and controlled.”

***

That was the issue with Bethany’s step-father. His opioid use was not being carefully monitored or controlled by his doctors and the hospital.

And even though everyone around her seemed to know about it, she said, no one would talk.

Until someone finally did.

“Looking back now, as a mother of three, I am in shock that it took someone as long as it did to make the call,” she said.

After hearing that Bethany’s dad was slurring his words and saying really hateful things to her, a friend’s mom spoke up.

“It was humiliating, and at the same time, I felt like I was going to be in trouble for exposing our family secret,” she said.

***

Six organizations representing Missouri healthcare providers issued recommendations in December to reduce opioid painkiller misuse and abuse.

The Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association and Missouri State Medical Association jointly recommended that healthcare providers adopt the recommendations.

Many of the state’s emergency departments have existing systems, however, there has not been a consistent set of guidelines statewide for providers throughout the state.

Dr. Evan Schwarz, Fellow of the American College of Emergency Physicians and MD at Barnes-Jewish Hospital in St. Louis, said emergency physicians deal with opioid misuse and abuse on a daily basis.

“This is an important initial effort to address the problem of prescription drug abuse,” he said. “However, in the long run, it will require a multi-disciplinary, public-private approach to provide treatment, reduce abuse and its costs.”

***

Shortly after the call about her step-father’s behavior, law enforcement officers and a Family Services representative visited Bethany’s home.

They discussed what had been reported and her mom reassured them they were fine and that Bethany had exaggerated the situation.

“A pot of coffee later, they were driving away,” she said, feeling even more hopeless about the situation.

However, a follow-up visit came shortly thereafter, and with it, a stern warning that her step-father needed to get help.

Nine days later, they moved halfway across the country.