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Veteran journalists and expert share ideas on how to better cover the opioid crisis

Veteran journalists and expert share ideas on how to better cover the opioid crisis

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As the United States faces a worsening opioid drug crisis, health experts offered an overview of the epidemic, explored the rise in toxic drug combinations, and suggested new ways of approaching the story in a webinar hosted by the Center for Health Journalism this week.

“We are in the midst of a severe epidemic that’s fueling record high levels of opioid overdose deaths,” said Dr. Andrew Kolodny, the co-director of Opioid Policy Research at the Heller School for Social Policy and Management at Brandeis University.

Kolodny, also the executive director of Physicians for Responsible Opioid Prescribing, said the crisis is a story of addiction and over-prescribing rather than simple drug abuse. Journalists Lisa Girion, top news editor of the Americas for Reuters, and Kimberly Kindy, a national investigative reporter at The Washington Post, also dispelled common misconceptions about the people most affected by the epidemic and shared reporting tips from the epidemic’s frontlines.

Misinterpreting data

Since 2011, the number of prescription opioid deaths has plateaued while deaths involving heroin have sharply risen, Kolodny said.

“What you’re hearing is that the pain killer problem has turned into a heroin problem,” he said. “That makes for a good story — the government tries to tackle one problem and inadvertently creates a new problem — but that isn’t really what’s going on.”

People are not suddenly switching from painkillers to heroin, he said. Instead, two different groups are addicted: younger Americans are using heroin and older Americans are using prescription drugs. He attributed the steep rise in heroin deaths in 2011 to synthetic opioids such as fentanyl, which dramatically increases the potency and toxicity of heroin.

The country is dealing with an addiction epidemic, not an abuse epidemic, Kolodny said, the result of the medical community over-prescribing opioids. He also blamed opioid manufacturers that encouraged providers to treat pain with the prescription painkillers. And, Kolodny also pointed a finger at state medical boards for their failure to discipline doctors, even when a complaint is registered against a provider for over-prescribing.

Addressing the opioid epidemic should mirror efforts to combat diseases such as HIV or Ebola, Kolodny said. First, new cases need to be prevented. Second, people who have the disease need to receive treatment.  

Those goals can be achieved, in part, through “much more cautious” prescribing of pain killers, cracking down on “pill mills,” and improved access to treatments such as buprenorphine, a medication which has been shown to reduce opioid overdose deaths.

The media plays a critical role by providing an accurate portrayal of the epidemic and its root causes, Kolodny said: “The problem is not abuse — both pain patients and recreational users are becoming addicted.”

Dispelling the conventional wisdom

In her reporting for the Los Angeles Times, investigative journalist Lisa Girion also took a critical look at another commonly-held belief about the opioid crisis: that it was being fueled by “bad people,” or teenagers popping pills for recreational use.  

Carefully examining data on death tolls gave Girion and her team pause. The death toll was highest for people in their 40s, which struck them as odd. Those who were dying were not the ones typically seen as driving the problem, she said.

Reporters gathered records on thousands of overdose deaths in Southern California over six years. In nearly half of the cases, one or more drugs prescribed for the deceased contributed to the death.

That was a “a game changer” in their reporting, Girion said.

Her team took a closer look at 298 patients under the care of 71 doctors with three or more patients dying of overdose from prescriptions they wrote. The average age was 48. 

“They weren’t people who were stealing from grandma’s medicine cabinet or having pill parties on weekends,” she said.

Instead, they were people who had experienced injuries on the job or car accidents, and got involved with doctors to help with pain.

The linchpin in the “Dying for Relief” series was coroners’ reports for suspected overdoes. The reports included information such as detailed pill bottles collected at the scene, with the names of prescribers on them.

With those 298 patients, the reporting team dug in and evaluated whether these patients should have been prescribed an opioid in the first place. Reporters looked for red flags for addiction in these patients’ medical histories, such as attending rehab, suicide attempts or mental illness. All but five patients had at least one such red flag.

Subsequent reporting delved into the role of drug maker Purdue Pharma and what the company knew about high prescribers and suspicious pharmacies.  

Drug combinations take devastating toll on middle-aged white women

Investigative reporter Kimberly Kindy started her opioid investigation for The Washington Post with a guiding question: Why is there a growing rate of premature death among middle-aged white women? 

The answer led her to Bakersfield, California, where she focused her on-the-ground story telling.

Before visiting the area, she “burned the phone lines,” reaching out to church leaders at mega churches, county mental health workers and psychologists. She connected with Ellen Eggert, a supervisor for the Kern County Mental Health Department who ended up being her “door opener.”

Eggert, who lends support to those at risk for suicide and families affected by it, led Kindy to numerous sources, including the women she used as the face of her story. In the piece she reported with data journalist Dan Keating, Kindy told the story of Karen Franklin, a woman who was taking more than a dozen different prescription drugs. Her journey to addiction started with a back injury and unraveled from there. “One thing seemed to lead to another,” Kindy said. 

Kindy interviewed experts who explained how opioids can lead to other drugs such as sleeping pills. She looked into the potentially devastating impact these drugs in combination can have on one’s body. When she needed a burdensome number of public records from the coroners, her “door opener” Eggert helped her yet again.

Kindy said she’d like to see more reporters examine the problematic combination of anti-anxiety drugs known as benzodiazepines and opioids: “There’s a whole huge area of coverage and policy questions that could receive more attention.”

Addressing the epidemic requires local, community-oriented support systems for people who are using pain killers to numb the pain of their lives, she said, arguing against a top-down national solution.

“It’s a local issue and that means communities need to mobilize and find ways to address these problems,” she said. 

When you look at the counties across the country that are hit the hardest by this crisis, their demographics vary greatly, Kolodny said. They do share one thing, though, in common: “It’s where (opioids) are prescribed aggressively … They are overprescribed by the medical community.”


Watch the full webinar presentation here:


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Why don't we see stories covering the millions of pain patients who are or were prescribed opioids for many years. That have been able to function for work & their families??

Most without these prescriptions will not be able to work or function. There is no quality of life. Many are committing suicide since scripts have been drastically reduced or just taken away.

There's a huge number in difference to those "addicted" vs "dependant" .

Why are we punishing patients by taking away the one thing that helps?? Patients have been through all other procedures and treatment plans, for many only one works.

The one they want to take away.
Most pain patients guard their meds with their lives, don't share or sell, don't ask for more, etc. They take as prescribed just to get through the pain and be able to function with every day life.

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Dear Kellie, Thank you for your reporting. I am Dr. Evan Mahoney, (Doctor of Acupuncture and Oriental Medicine) . I specialize in the treatment of pain. Pain involving musculo-skeletal and structural complaints. It has been my experience that most cases of pain can be resolved quite simply by stretching. Especially for Acute Pains which are usually first manifestation of muscle shortening / tendonitis variety. I have experienced many times patients coming to me after visiting their Doctor who recommends prescriptions as the first line of treatment. Most of these doctors must not have training in simple stretching that can alleviate pain (probably because it does not pay for them to teach stretching). I have seen cases of failed and unnecessary back surgery where all a patient needed was to learn a simple decompression stretch of the back that would have gotten them out of pain. It is a tragedy. The public needs to be made aware that in most cases of pain (especially acute) stretching should be the First Line of Treatment. In my practice I combine acupuncture with stretching or stretching alone. This is called "Korean Kinetic Acupuncture" from doctors whom I have studied and practiced with. To break the chain from pain to surgery to opioid's we must teach stretching as the First Intervention in pain. I have written several books on acupuncture, meditation, and stretching. Including "Eliminate Back Pain - Hang From a Tree" and "Fountain of Youth Stretching". These are the techniques I practice in my clinic to great effect on many of my patients. I hope you can find a story in stretching as the first line of intervention for pain. IMO it is thoroughly under reported and the public is mostly under aware. Thank you. Dr. Evan Mahoney

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I just need to weigh in as one who has lived with severe, chronic pain from multiple maladies and over many years: Journalists and their policy making friends really need to stop chasing the ‘fox’ for a bit...get their ‘hound’ under control...and stop, look and a quick 360 and survey the entire field.

This is a question of scope, of course—and of strategy. Death tolls from the ‘crisis’ get top-of-the-page coverage. But reporters, editors, and those in investigative/regulative positions need to examine the entire sweep of the radar. What is the ratio of overprescription/abuse to appropriate prescription/self-controlled use?

I can state with confidence that I would not be alive to write this were it not for the morphine—prescribed by my doctor of 25 years. I know I may very well have ended my life without this drug or something like it. I should state that haven’t been using for that long; it’s been 9 years. Difficult years...for every benefit of the drug, there are at least several disadvantages, to put it mildly.

But to move, to be able to move, think, and work, I needed it for a while. I still take it, but have, over 6 very long and difficult years of tapering down on the daily dosage, reduced my intake by 93%. Nota bene: NONE of the offending pain sources (kidney stones is one) have left me, and I am apparently coming down with a horrible, rapid-onset rheumatoid arthritis thing. The morphine does help. But I am committed to total discontinuation. Nota bene #2: Because of the RA, it’s taken me 45 minutes to compose this comment!

Yet I am, on the other hand, willing to admit that I can be classified as an “addict” under the current volkspolitik that media reporting has had a huge hand in creating...but feeling completely misunderstood, mischaracterized, and—yes—lies about.

I’ve been teaching communication, journalism, leadership and good governance in major universities now for 30 years—and have very seldom seen the kind of tunnel-vision, libel against entire categories of people, and a hype-driven narrative that appears to be completely devoid of how it hurts those who hurt most.

My goal is to be morphine-free. I’m nearly there. But “Journalism” and its cadre needs to think very critically about themselves and their approach to this sexy new meme.

Perhaps a timely clue would help: What percentage of journalists chasing this ‘fox’ are opioid-addicted? I’m having a VERY difficult time finding any reportage on this question!


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