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The Opioid Octopus
Nestor A. Ramirez-Lopez, MD
ISMS President
Nestor A. Ramirez, MD, MPH

The opioid epidemic affects the health of millions of our country's citizens. After hearing or reading about it almost daily, we tend to become numb to its very serious effect on our communities – but for the sake of the 116 people who die from an opioid overdose every day, and for their loved ones, we must stay engaged.

Lawmakers and public health authorities have struggled to find and implement effective solutions to this critical issue. As individual physicians we sometimes think that the efforts of one person will be ineffective in dealing with such a large-scale crisis despite all the tools we have to treat our own patients. There may not be a "silver bullet" to stop the opioid crisis in its tracks, but every concerned individual can be a significant part of the solution.

Recent efforts to provide naloxone to addicts, to make it available without a physician prescription, and to train first responders in its use are important life-saving steps. However, they do not treat the underlying problems that led to an overdose. The opioid crisis is like an octopus with many tentacles. Each of them is different in scope, and various groups focus on addressing different parts of the issue, but they all need to be dealt with in a coordinated and collaborative manner.

Physicians, pharmacies, state health departments, manufacturers, federal agencies, members of the community, and schools – they all have an ongoing role, and they need to continue fulfilling it. Each person in our towns and cities can be an advocate and a support for friends, neighbors or relatives who may be having opioid issues.

All of us can help by preventing drug diversion. Urge your patients to check the places in their home where they might have ANY medications that are no longer used and dispose of them safely. Many pharmacy chains and law enforcement agencies accept unused medications year-round. The DEA holds special collection days twice per year. The next national take-back day will be on April 28, 2018. ISMS has a resource page with information on medication disposal, which includes a link to find disposal sites.  Consider sharing the link ( www.isms.org/Take-Back) through your practice web site and social media accounts.

As physicians, we can educate patients, help prevent opioid misuse, and treat opioid use disorders. Whatever you do to help today, try to do the same, or much more, tomorrow and every day after that. Don’t give up – you may be the last line of defense for your patients.


I look forward to hearing from you. I can be reached at DrRamirez@isms.org.



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