By Sarah Werner, D.D.S.
From the Winter 2018 Journal of the Colorado Dental Association
Cemeteries reveal a lot about our life and times. A modern headstone identifies the person and states a birthdate and day of death. Older head stones are different. They display grief and lamentations. Old gravesites of children are especially poignant, with their time on earth noted in years, months, weeks and days to commemorate each precious moment of a life lost and to display the grief and pain of the survivors.
The modern life, like the modern headstone refuses to acknowledge grief and pain, two very integral experiences of living. We have come to believe that we are entitled to a pain free world. Pain is inconvenient, it’s awkward and it interferes with our schedules. As health practitioners, we, of course, want our patients to suffer as little as possible. Patients have come to expect a “pain free” experience and we may placate them with prescriptions for “pain killers.” We may over medicate because we don’t want to be associated with or blamed for pain. In attempts to eliminate pain, we condemn a generation by making prescription opioid narcotics too easily available and too easily replaced with a stronger, cheaper alternative: heroin.
Heroin is in Colorado. According to the report, “Heroin in Colorado,” published by the Heroin Response Work Group (a working group under the Colorado Consortium for Prescription Drug Abuse Prevention), Colorado law enforcement agencies increased heroin seizures by 2,035% between 2011 and 2015. Deaths related to heroin tripled between 2011 and 2016 from 79 to a staggering 228. Pueblo County had the highest rate of heroin overdose, followed by Denver County and the southeast corner of Colorado. A survey conducted by Denver methadone clinics revealed some surprising demographics. Almost half of the respondents had one-to-three years of college and rented or owned their own home. The majority (70%) said prescription pain killers had a decisive role in their decision to use heroin, with the median age of first-time prescription drug abuse at 18 years. One third of the respondents said they got the prescription opioid from a doctor, and another one third said they got it from a friend.
As prescribing practitioners, we have a responsibility to evaluate our pain management protocols. Over-the-counter pain relievers are appropriate and adequate for the majority of our patients and if an opioid prescription is warranted, dosages must be limited. Opioid abuse is a public health crisis in Colorado. Prescribers and patients alike must understand the urgency of combating this disease.
Written in memory of my beloved nephew, Jon, who died in Denver of a heroin overdose at age 19 years, 4 months and 1 week.
For further information please contact the Colorado Consortium for Prescription Drug Abuse. The Center for Health Work and Environment, part of the University of Colorado School of Public Health, has an online, one-hour self-paced course for dental providers.
About the Author: Sarah Werner, D.D.S., is a general practitioner in Denver.