SALT LAKE CITY — When it comes to Utah's opioid abuse crisis, Salt Lake Police Chief Mike Brown said the problem "crosses every socioeconomic boundary you know."
On Thursday night, an all-star panel of medical providers, law enforcement officials and patients gathered to talk about prescription painkiller abuse.
For nearly two hours, panelists and audience members wrangled with the delicate and dangerous task of how to treat pain while avoiding addiction.
Imagine a dime, said Jan Chambers, head of the National Fibromyalgia and Chronic Pain Association, with addiction on one side and pain on the other.
"As we roll that dime forward, we have to treat both communities," she said. "We can't leave one out."
The roundtable was sponsored by the Utah Academy of Pain Medicine and Pfizer Inc., which has a long-acting, abuse-resistant opioid painkiller currently undergoing FDA review.
None of the panelists was paid to appear, said Krista Albert, a spokeswoman with public relations firm The Summit Group, who represents Pfizer.
Nobody in the medical community — not doctors, not insurers, not pharmaceutical companies — should be let off the hook when it comes to the current opioid abuse problem in the U.S., said Dr. Michael Jaffe, a physical medicine and rehabilitation doctor with Intermountain Salt Lake Clinic who led the discussion.
Physicians were taught that opioid painkillers were "relatively benign" for years, Jaffe said, and at some point, they became accessories to a nationwide drug habit.
Dr. Lynn Webster, past president of the American Academy of Pain Medicine, called doctors "woefully and inadequately trained" to treat pain.
"I think we’ve ignored people in pain forever," Webster said. "And then when we decided we were going to help them, we used the one tool that was in our armamentarium — and it’s not a very effective tool and it’s a dangerous tool."
In 2014, 290 people in Utah died from opioid overdoses — a number that has nearly quintupled since 2000.
Although law enforcement officials can cut into drug supply, they have a hard time reducing demand, Brown said.
When patients are cut off from their prescriptions, they turn to the streets, where a 30 milligram pill of oxycodone goes for $30, he said. And when pills become too expensive, people turn to heroin, usually spending $100 to $150 a day on their habit.
"There are hundreds and hundreds of people that we see in that situation near the Pioneer Park area and shelter area," Brown said. "We’ve been unable to really measure the amount of crime that it takes to supply these habits, but I’m telling you, it’s huge."
Yet police are limited in what they can do, according to Brown, who added that for all the people they arrest, few options are available to treat their addiction in a meaningful way.
Chambers criticized insurers for not lowering the price of alternative treatments, like physical therapy, behavioral therapy and abuse-resistant opioid formulations.
"From the patients' perspective, insurance companies are holding us all hostage," she said.
Bridget Shears, the pain services program manager at Intermountain Healthcare, detailed some initiatives from the health care system, including no-questions-asked drop boxes at their pharmacies and wider distribution of the overdose reversal drug naloxone.
Could medical marijuana be an option? Panelists discussed that too.
Scott Reed, a Utah assistant attorney general, said he believes medical legalization is an "inevitability" but said states' hands are tied while the drug is still considered illegal on the federal level.
He called on lawmakers to reclassify the drug from a schedule I controlled substance to schedule II — something the Utah Legislature supported in a resolution in the 2016 legislative session.
"It is, to us, here on the ground, the simplest of solutions that hasn't seemed to make its way up into the ether of Congress," Reed said.
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