WATERLOO — Rod Courtney’s 15-year-old granddaughter came home after surgery last year with 40 opioid pills in her pocket.
Courtney couldn’t believe it. Just four years after his son overdosed on fentanyl after his opioid addiction spiraled out of control, Courtney realized nothing had changed about doctors’ prescribing practices when it came to the addictive pain medication.
“I was just outraged,” the North Liberty man, who now runs Community Resources United to Stop Heroin of Iowa, said Wednesday. “How is that still taking place, and why? I just can’t wrap my head around that.”
U.S. Sen. Joni Ernst, leading Wednesday’s opioid roundtable discussion at the Van G. Miller Adult Learning Center in Waterloo, posed his question to the group of nine doctors, addiction specialists and others.
“Can someone explain why?” Ernst asked.
Physicians are being squeezed on all sides, said Andrea Weber, assistant director of addiction medicine at the University of Iowa Hospitals and Clinics. They neither have the time to sit down and have conversations with patients about pain management like they used to, nor do they want a call in a few days requesting more pain medication.
“The result of that is we tend to do stuff like prescribe more medications, rather than have true conversations,” Weber said.
Others said doctors are more likely to prescribe the medication that alleviates the most pain the quickest to get better patient satisfaction scores that lead to better reimbursement, said Adriane Argenio, a general surgeon with MercyOne Waterloo.
“There’s a feeling that the expectation of the public is that there will be no pain after surgery. There’s going to be pain,” she said. “So we get into this routine of giving opioids so we’re aligning with the patients’ goal of no pain, which is not realistic. We’re incentivizing the wrong things.”
Most at the roundtable said a good first step was the Non-Opioids Prevent Addiction In the Nation Act, or NOPAIN Act, which was introduced in the U.S. House of Representatives in November and the U.S. Senate in December.
The bill amends the Social Security Act to promote “access to non-opioid treatments in the hospital outpatient setting” by modifying Medicare’s outpatient policies.
Ernst was one of four original co-sponsors of the bill and the lone Republican co-sponsor at the time, along with original sponsor Sen. Shelley Moore Capito, R-W.Va. It now has 14 co-sponsors in the Senate, an even split of Democrats and Republicans. But the bill has languished in the Senate Committee on Finance since.
“This is a very easy way, this bill,” said Tyler Roberts, director of federal affairs for Voices for Non-Opioid Choices. “This is a common-sense approach that can really help us solve this crisis upstream.”
Ernst said she’d “keep pushing” for the bill’s passage.
“I think this is really important to prevent (addiction) where we can, and we can do this through this legislation,” she said.