Reversing the opioid epidemic

Pain expert argues for systematic effort

By Tony Gottschlich, BWC Public Information Officer, Media Relations

The opioid crisis afflicting the nation is “the worst man-made epidemic in modern medical history” and the United States needs a systematic effort to reverse it, a leading pain and workers’ compensation expert told a group of Ohio employers and workers gathered for the Ohio Safety Congress & Expo Wednesday.

“At least 7-10 million patients in the U.S. who are on chronic opioids are highly dependent or addicted,” said Gary Franklin, MD, MPH, a neurologist and medical director of the Washington State Department of Labor and Industries. “They’re in deep trouble and there’s no systematic effort out there to help them. Most go to their primary care doctors, who have no idea what to do, and a lot of these patients are getting abandoned. That’s the worst thing that can happen.”

Franklin’s lecture, entitled, “Reversing the Opioid Epidemic and Improving Pain Care,” was one of dozens offered on the opening day for Safety Congress, the annual safety and occupational health event sponsored by the Ohio Bureau of Workers’ Compensation (BWC) and held at the Greater Columbus Convention Center.

Franklin said if this country is serious about reversing the opioid epidemic, it needs to do three things:

• Prevent the next wave of opioid users. Research shows most opioids don’t help most chronic pain patients. Many get worse and fewer return to work. Prescribe non-opioid analgesics as a first-line treatment.
• Systematically address and treat the millions or patients already on long-term opioids.
• Deliver community based, multimodal care for pain. There is strong evidence supporting cognitive behavioral therapy and psychologically informed physical therapy, he said.

And perhaps the most obvious of all: “If your patients aren’t improving, don’t give them more opioids.”

“This is a mess, and it’s our job as public servants to figure out how to help these patients,” said Franklin, who is also a research professor at the University of Washington.

While giving an overall bleak assessment of the opioid crisis and its challenges, Franklin paused in his lecture to compliment the Buckeye state, pointing to Gov. Mike DeWine’s RecoveryOhio plan and BWC’s Substance Use Recovery and Workplace Safety Program.

He ended his lecture with another positive note. “I do think we’re all in this together and we can figure it out.”

Franklin was joined in the lecture by Dr. Terry Welsh, BWC’s chief medical officer, who spoke about the substance use recovery program and other BWC efforts to mitigate the impact of the opioid crisis on the workforce. Also speaking was Tom Wickizer, a professor of public health at The Ohio State University. Wickizer made a case for an occupational health care model that can prevent long-term and/or permanent disability.