Once again, headlines from across Vermont have highlighted recent overdoses as a result of the opioid crisis. In a few cases, the individual’s addiction has become a signal to others.
An obituary for Megan Angelina Webbley, 31, was heartbreaking.
It stated, in part, “she died of an overdose, finally losing her battle with addiction. She was in Manchester, N.H., seeking treatment for her addiction.”
Webbley was the mother of four “who were collectively the light of her dark life,” her family wrote. The obituary details an accident in 2005 — a singular moment — that is believed to be the beginning of the final chapter of Webbley’s troubled life: the beginning of an addiction to pain killers. “She would be in and out of rehab — and jail — for the next 14 years.” She would also lose her children.
In the obituary, her family pleaded: “We, as a state, are overwhelmed by addiction. We have almost nowhere to turn. I encourage enhanced funding for treatment in general and using DCF as a gateway for mothers with addiction to get help. Because, as one would guess, once the mother is separated from her children, desperation sets in, even with the brightest and most determined of mothers — and Megan Angelina Webbley was that bright and determined mother… with a fatal disease and a dearth of treatment options.”
We all know people affected by this plague. We all know about the hub-and-spoke approach to treatment. And we all know how sinister addiction can be to a relationship, a family, a neighborhood, a community and a state.
We live it every day.
So it is a relief when precautionary steps are taken — at any level.
This week, U.S. health officials again warned doctors against abandoning chronic-pain patients by abruptly stopping their opioid prescriptions.
The U.S. Department of Health and Human Services instead urged doctors to share such decisions with patients. The agency published steps for doctors in a six-page guide and an editorial in the Journal of the American Medical Association.
According to that editorial, prescription opioid use continues to contribute to significant morbidity and mortality in the United States. In 2017, 17,029 of the 47,600 opioid-related overdose deaths involved prescription opioids. Nearly 2 million individuals in the United States have a prescription-opioid use disorder. At the same time, approximately 11% of U.S. adults report daily pain, and an estimated 3% to 4% use opioids long-term to help manage chronic pain.
In the 1990s, overprescribing started the first wave of the nation’s overdose crisis. Opioids — previously used mostly for patients with cancer, at the end of their lives or with pain after surgery — began to be prescribed for long-term pain such as backaches. Drug companies promoted that use, even as evidence grew of addiction and overdose.
Later, insurers and hospitals misinterpreted cautions about opioids in ways that harmed some patients. Some turned to street drugs such as heroin or fentanyl after doctors stopped prescribing.
In April, the Food and Drug Administration added new label advice to drugs such as OxyContin, Vicodin and dozens of generic pills after reports of suicide and other serious harm in patients who were physically dependent on opioids suddenly having the medicine stopped or their dose rapidly decreased.
In the new guide, health officials said slow, voluntary reductions of opioid doses can improve quality of life without worsening pain. Tapering the drugs slowly can take months or years.
The editorial notes: “While safe and effective opioid use and discontinuation can be challenging, the Centers for Disease Control and Prevention guideline and the HHS guide emphasize that clinicians have a responsibility to provide care for or arrange for management of patients’ pain and should not abandon patients. … More research is critically needed to define optimal strategies for opioid tapering. … Unless there is a life-threatening issue, such as imminent overdose, the benefits of rapidly tapering or abruptly discontinuing opioids are unlikely to outweigh the significant risks of these practices. However, following slow, voluntary reduction of long-term opioid dosages, most patients report improvements in function, quality of life, anxiety, and mood without worsening pain or with decreased pain levels.”
That is no consolation to the family of Megan Angelina Webbley. But because of steps being taken by the medical profession, and the courageousness of families who stand up to remind us that these addicts are our family members, friends and neighbors, we are staring down this plague with the indignation it deserves.