By Mary Cashin |ContributorFor Dr. Richard Sams, associate professor of family medicine at the Medical College of Georgia at Augusta University, the opioid epidemic is a major failure on the part of the medical community from which patients continuously reap the consequences.In an interview, Dr. Sams explained that the cause of the current opioid crisis that plagues the United States started because the medical community had a reputation of under-treating people for pain during the hospice movement in the late 1960s. Because of this, in the 1980s and 1990s, pain specialists developed, and marketers of opioids thrived. The main culprit has been Purdue Pharmaceuticals, which heavily embedded their product, oxycodone, into the medical community.The Georgia Department of Public Health states that there is an "opioid abuse epidemic in Georgia" and lists as opioids the illegal drug heroin, synthetic opioids such as fentanyl and pain relievers available legally by prescription, such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine and morphine.“They popularized this idea that number one, it was an imperative for us to do it, that we should do it, that we must do it, and that it was safe to do it,” Dr. Sams said on how large pharmaceutical firms, in particular Purdue, pressured physicians into prescribing opioids during the late 1990s and early 2000s.Twenty years later, the nation is fully immersed in an opioid epidemic, with the death toll related to prescription opioids upwards of 220,000. Georgia is below the national average for deaths from opioid overdose, according to the National Institute of Drug Abuse (NIDA). In 2017, Georgia had 1,014 overdose deaths involving opioids. The Georgia rate of 9.7 deaths per 100,000 persons is lower than the national rate of 14.6 deaths per 100,000 persons, according to the NIDA. The death rate both in Georgia and the nation as whole has been on the steady increase since 1999.And while Georgia might be in the lower tier of the states impacted by the epidemic, it is still a problem, as the state department of health has noted. It is clear that no medical practice is immune to widely prescribing opioids, as Dr. Sams talks of his experience with the opioid epidemic at his own clinic at Augusta University.“When I showed up in my clinic, we’d have people coming in and saying, ‘I have chronic knee pain and I need my refill, my opioids,’ and almost no documentation of what the source of the pain is or how long they’ve had the pain,” Dr. Sams said.This casual manner of prescribing opioids to patients without monitoring the improvement of patients is dangerous as it facilitates the development of addiction to opioids.How dangerous are opioids? According to Dr. Sams, they are significantly more addictive than other substances, as they alter a patient's brain chemistry dramatically.“The medicines change your brain chemistry so dramatically that it almost is like the air you breathe, you have to have it,” Dr. Sams said.When people become addicted to these substances, they divert them to the street, and the more casually physicians prescribe the substance, the greater the issue becomes.“We as prescribers, and my own clinic actually, this is what gave me the interest in pursuing this," he said. "When I first got to my clinic, out of 17,000 patients, we had probably close to 500 to 700 people who were on very high dosages of long-term opioid therapy, just being prescribed very casually."In terms of solutions, Dr. Sams talked about research released in 2017 pertaining to the inferiority of opioid therapy to other pharmalogical interventions, by using medications such as Tylenol or muscle relaxers. Locally, therapies like massage, acupuncture and cognitive behavioral therapy are used at the Eisenhower Army Medical Center in Augusta.“They’ve dramatically reduced by more than 50 to 60 percent the use of opioids for chronic pain,” Dr. Sams said of improvements with the implementation of alternative methods for treating pain at the Eisenhower Army Medical Center.Overall, the opioid epidemic continues to cause problems across the nation with overdoses and deaths continuously on the rise. And with that, Dr. Sams had one last thing to say about the epidemic and the medical community:“It’s fairly unnerving,” Dr. Sams said. “We act as if we have scientific rationales. All of that was anything but rational or scientific. It was mostly driven by money; that is, it was driven by anything but the patient’s welfare.” Contact Mary Cashin at MCASHIN@augusta.edu.