Friday, February 3, 2023
ISSN 2765-8767
  • Survey
  • Podcast
  • Write for Us
Daily Remedy
  • Home
  • Articles
  • Podcasts
    A conversation with Dr. Selwyn O. Rogers, trauma surgeon and gun policy expert

    A conversation with Dr. Selwyn O. Rogers, trauma surgeon and gun policy expert

    November 25, 2022
    A conversation with Dr. Kyle Fischer, policy director for the Health Alliance for Violence Intervention

    A conversation with Dr. Kyle Fischer, policy director for the Health Alliance for Violence Intervention

    November 25, 2022
    A conversation with Dr. Edwin Leap, physician writer and emergency medicine physician

    A conversation with Dr. Edwin Leap, writer and emergency medicine physician

    November 8, 2022
    A conversation with Mr. Omar M Khateeb, innovator in medical device sales

    A conversation with Mr. Omar M Khateeb, innovator in medical device sales

    October 31, 2022
    A conversation with Miss Smriti Kirubanandan, passionate healthcare strategist

    A conversation with Miss Smriti Kirubanandan, passionate healthcare strategist

    October 23, 2022
    A conversation with Mr. Michael Johnson, legal expert in physician contracts

    A conversation with Mr. Michael Johnson, legal expert in physician contracts

    October 23, 2022
  • Surveys

    Surveys

    Does inflation affect how you use your deductible?

    Does inflation affect how you use your deductible?

    by Jay K Joshi
    December 12, 2022

    Survey Resutls

    How strongly do you believe that you can tell when your provider does not trust you?

    How strongly do you believe that you can tell when your provider does not trust you?

    October 16, 2022
  • About Us
  • Contact us
  • Support Us
  • Purchase DME
No Result
View All Result
  • Home
  • Articles
  • Podcasts
    A conversation with Dr. Selwyn O. Rogers, trauma surgeon and gun policy expert

    A conversation with Dr. Selwyn O. Rogers, trauma surgeon and gun policy expert

    November 25, 2022
    A conversation with Dr. Kyle Fischer, policy director for the Health Alliance for Violence Intervention

    A conversation with Dr. Kyle Fischer, policy director for the Health Alliance for Violence Intervention

    November 25, 2022
    A conversation with Dr. Edwin Leap, physician writer and emergency medicine physician

    A conversation with Dr. Edwin Leap, writer and emergency medicine physician

    November 8, 2022
    A conversation with Mr. Omar M Khateeb, innovator in medical device sales

    A conversation with Mr. Omar M Khateeb, innovator in medical device sales

    October 31, 2022
    A conversation with Miss Smriti Kirubanandan, passionate healthcare strategist

    A conversation with Miss Smriti Kirubanandan, passionate healthcare strategist

    October 23, 2022
    A conversation with Mr. Michael Johnson, legal expert in physician contracts

    A conversation with Mr. Michael Johnson, legal expert in physician contracts

    October 23, 2022
  • Surveys

    Surveys

    Does inflation affect how you use your deductible?

    Does inflation affect how you use your deductible?

    by Jay K Joshi
    December 12, 2022

    Survey Resutls

    How strongly do you believe that you can tell when your provider does not trust you?

    How strongly do you believe that you can tell when your provider does not trust you?

    October 16, 2022
  • About Us
  • Contact us
  • Support Us
  • Purchase DME
No Result
View All Result
Daily Remedy
No Result
View All Result
Home Politics & Law

Addiction Isn’t a Metric

Jay K Joshi by Jay K Joshi
June 28, 2022
in Politics & Law
0
Addiction Isn't a Metric

It is an art form – making the simple appear difficult. Many politicians have built career-defining legacies on that art alone. And now, Dr. Rahul Gupta joins the illustrious ranks of politicians cum policy makers engaging in the art.

In recent days, he announced a metric, not for a rare cancer or some complex socioeconomic ill, but for the most overt manifestation of addiction. Specifically, he called for reducing the number of overdoses by a curiously exact 13 percent.

He made it seem so grandiose, so difficult in scale that he had to formally announce it. But lost in the rhetoric of rising overdoses and the ever-splitting moral fabric of America is one crucial fact: Addiction is not a metric.

In fact, to understand addiction, we have to avoid this tendency of thinking in terms of acute clinical metrics. Addiction is not a singular event that can be measured and understood by one outcome alone. Rather, it is a complex blend of decisions and actions that can be best understood like other chronic diseases.

It may seem far-fetched to think of addiction in the same way that we do diabetes or hypertension, but the analogy is more apt than what most policy makers would believe. Addiction is the culmination of multiple decisions, some overtly clinical, and some more subtle, more existential.

It is why we see overdoses rise in towns where factories have closed. It is why despite fewer opioid prescriptions we see increasing rates of fatal overdoses. And it is why, despite our best efforts to raise awareness on the harms of drug use, we keep finding more and more potent drugs.

Amidst this complex pattern of behavior lies the genesis of addiction. The very disease itself challenges our perceptions of medicine – and through a close examination of addiction, we find contextualizing the disease through metrics like overdoses to be both limiting and harmful.

It exposes us to biased thinking, which often appears in healthcare when we focus our attention on a single metric. Inevitably, in our zest to achieve the targeted metric, we fail to account for the emerging second and third order consequences.

For example, many of the antibiotic resistant infections that we see of late began through our aggressive use of antibiotics, to eliminate – at all costs – any infection. Only we never got rid of the infections, we just made them resistant to antibiotics, and consequently more difficult to treat.

Similarly, focusing on a single metric, overdoses, to address and treat the opioid crisis paves the way for additional, unforeseen consequences that will have deleterious effects – some of which will be inadvertent and some in bad faith.

As we saw during the pandemic, healthcare systems and health policy makers manipulated data to reduce or inflate the number of COVID deaths, depending on their underlying motivations. In the same vein, we will see distorted data similarly reducing or inflating fatal overdoses.

More importantly, emphasizing an overdose event alone does not address the origins of addiction. It does not begin with the unconscious patient being rushed to the emergency department unconscious after taking a batch of heroin laced with too much fentanyl. It begins with a work injury, after a patient fails to find appropriate clinical care. It begins after a layoff, a divorce, or returning from a combat tour, only to find no job opportunities.

Addiction ends with overdose. But it begins insidiously and becomes overt only after years of conscious and unconscious decisions and actions that lead a patient down a slippery slope of dependency to addiction.

Focusing on overdoses is like collecting drops of water while ignoring the vast expanse of the ocean. It will do little to nothing in addressing the opioid epidemic, and it will make things worse for patients with nascent substance dependencies.

Just like the government’s efforts to reduce prescription opioids made things worse for patients with chronic pain, prioritizing overdose events will make life worse for patients with addictions. Hospitals will fear caring for such patients, leery of incurring poor marks for higher than average overdoses. Soon we will see healthcare systems reject patients with substance use dependencies, prioritizing the overdose metric itself over the actual care of patients.

In short, by emphasizing a reduction in overdoses as the metric for success, we destroy the value of that metric to monitor addiction as a clinical condition. But that is something Dr. Gupta and other proponents of harm reduction should have already known.

The ONDCP must do better than this.

ShareTweet
Jay K Joshi

Jay K Joshi

Dr. Jay K Joshi serves as the editor-in-chief of Daily Remedy. He is a serial entrepreneur and sought after thought-leader for matters related to healthcare innovation and medical jurisprudence. He has published articles on a variety of healthcare topics in both peer-reviewed journals and trade publications. His legal writings include amicus curiae briefs prepared for prominent federal healthcare cases.

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Videos

YouTube Video VVUxUDVQenU5RTFjUVFKNDY2ZlBmdFB3LmdVUm55WVpqRmNn This is a video about Elemental/Essential Frameworks of Healthcare Law

00:00 Elemental/Essential Frameworks of Healthcare Law
Load More... Subscribe

Expert vs. Lay Testimony

Visuals

NADAC (National Average Drug Acquisition Cost)

NADAC (National Average Drug Acquisition Cost)

by Jay K Joshi
January 29, 2023
0

We list the acquisition price of drugs that are covered under the Medicaid Drug Rebate Program - effectively, how much does the government pay for common drugs utilized by patients on Medicaid. Drugs listed are from A-CH.  

Read more

Twitter Updates

Tweets by DailyRemedy1

Newsletter

Start your Daily Remedy journey

Cultivate your knowledge of current healthcare events and ensure you receive the most accurate, insightful healthcare news and editorials.

*we hate spam as much as you do

Popular

  • Malicious Prosecution and Fabrication of Evidence

    Malicious Prosecution and Fabrication of Evidence

    0 shares
    Share 0 Tweet 0
  • 2022 Letter to the American Medical Association

    0 shares
    Share 0 Tweet 0
  • 2023 Letter to the American Medical Association

    0 shares
    Share 0 Tweet 0
  • Letter to the Alabama Board of Medical Examiners

    0 shares
    Share 0 Tweet 0
  • Prosecuting Doctors as Drug Dealers

    0 shares
    Share 0 Tweet 0

Daily Remedy

Daily Remedy offers the best in healthcare information and healthcare editorial content. We take pride in consistently delivering only the highest quality of insight and analysis to ensure our audience is well-informed about current healthcare topics - beyond the traditional headlines.

Daily Remedy website services, content, and products are for informational purposes only. We do not provide medical advice, diagnosis, or treatment. All rights reserved.

Important Links

  • Support Us
  • About Us
  • Contact us
  • Privacy Policy
  • Terms and Conditions

Newsletter

Start your Daily Remedy journey

Cultivate your knowledge of current healthcare events and ensure you receive the most accurate, insightful healthcare news and editorials.

*we hate spam as much as you do

  • Survey
  • Podcast
  • About Us
  • Contact us

© 2023 Daily Remedy

No Result
View All Result
  • Home
  • Articles
    • Contrarian
    • Financial Markets
    • Innovations & Investing
    • Perspectives
    • Politics & Law
    • Trends
    • Uncertainty & Complexity
  • Podcasts
  • Surveys
    • Survey Results
  • About Us
  • Contact us
  • Support Us

© 2023 Daily Remedy

Start your Daily Remedy journey

Cultivate your knowledge of current healthcare events and ensure you receive the most accurate, insightful healthcare news and editorials.

*we hate spam as much as you do