Former medical director focuses addiction responsibility on prescribers

As the addictive properties of prescription painkillers are made more visible each year, Dr. Michael Saxe is trying to make people — doctors and patients alike — understand how we got here.

The Director Emeritus of Emergency Medicine at Middlesex Hospital, Saxe said he began an outreach tour of lectures to medical professionals and patients a year ago, when he started seeing opioid addiction become an increasingly important part of his job.

He speaks at public and private events across the state about the history of painkiller prescribing in the United States, putting the blame and responsibility on the decades of widespread overprescribing of addictive medications to patients who didn't need them.

His talks attract parents, medical professionals, work group members and people simply interested in the addiction epidemic that is on track to kill 1,000 people in Connecticut this year.

His focus, he said, is on the majority of heroin users who first become addicted to opioid painkillers prescribed to them by a doctor.

Drugs like Percocet and Vicodin, the brand names for opiates like oxycodone and hydrocodone, were for many years considered the best solution for patients who wanted to manage their pain, he said.

"The most common reason that patients visit doctors is pain," he said. And "until five years ago, we thought opioids were great options for treating pain."

"I think the tide is turning," Saxe said. "When you talk about 300 million people thinking a certain way ... it takes a while to turn things around."

He said prescribing regulations put in place by Gov. Dannel P. Malloy's administration have made a difference. So have efforts to educate prescribers about alternatives to opiate painkillers such as physical therapy or safer medications, like intravenous use of acetaminophen.

He says opiate painkillers shouldn't be 100 percent eliminated. But reducing the levels of prescribing those drugs by up to 80 percent would help, he said.

Patients play a role in that effort, too, he said. Aggressive drug marketing and decades of misguided pressure for doctors to automatically treat pain with opiates have caused patients to believe they should have access to drugs that will eliminate their pain, rather than help them manage it.

"We need to change the opinion that it's realistic to get to zero pain in everyone," Saxe said. "The goal should be function, not getting to zero."

"We're going to still see a lot of people with acute pain and chronic pain, and so we all need to be educated about, what are the options," he added.

Jill Adams, the head of Adult Services at the Waterford Public Library, said she heard about Saxe's lecture and wanted to bring him to Waterford, whose residents have been among countless New Englanders affected by addiction.

"It looks like it's hitting all demographics at this point," Adams said.

Since Saxe started speaking publicly about opiate prescriptions a year ago, he said more of his patients at Middlesex Hospital and the audiences at his lectures have begun to understand the danger of using the drugs to treat pain.

Just a year ago, he said, patients wouldn't understand when he suggested avoiding painkillers, even for a short time, because they are addictive.

"They would look at me with a furrowed brow, and they wouldn't know what I was saying," he said.

Now, after relentless media coverage of overdose deaths and awareness of the addictive properties of opioids, patients are starting to get it.

"They understand that what I'm saying is in their best interest," Saxe said.

Saxe will be speaking at the Waterford Public Library at 7 p.m. Monday, alongside Waterford police Chief Brett Mahoney.

Saxe has not previously included law enforcement in his talks but said police departments are seeing the worst effects of the addiction epidemic.

"Educating police, just as educating any members of the public, is extremely valuable," he said.

m.shanahan@theday.com 

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