Doctor: Lawyers will have role in navigating opioid crisis in Dayton

‘When the treatment becomes worse than the disease, we have a problem’

Too often physicians — or even nurses and medical assistants — cater to patients who expect pain-free lives, an expectation that helped open the door to the opioid crisis overshadowing much of Dayton and Southwestern Ohio, a Centerville physician told the Dayton Bar Association last week.

An occupational medicine and clinical research specialist, Dr. David Randolph said too often doctors or staffs indulge patients seeking relief from ill-defined “pain,” prescribing powerful narcotics that give the patients what they want, but not what they need.

“When the treatment becomes worse than the disease, we have a problem here,” Randolph said.

The destruction wrought by opioid abuse is making itself felt across all of society, prompting the Dayton Bar Association to invite Randolph for an address last week.

Overdose deaths rose 130 percent – from 37 during the first quarter of 2015 to 85 during the first three months of this year – according to a Montgomery County review released last month.

In late August, Cincinnati-area emergency rooms reported 174 overdose cases over six days, numbers that got national media attention.

For attorneys working with clients trying to navigate workers compensation and Social Security Administration claims, the goal must be to get people back to work free of drug-dependency, said Douglas Jenks, an attorney with Dunlevey, Mahan and Furry and committee chair for the bar association.

“The problem we’re seeing in Dayton … is increasing dependence on narcotics,” Jenks said. “But we’re smarter than that. And smart scientists like Dr. Randolph are starting to figure this out.”

Randolph sat down with the Dayton Daily New to discuss this issue and its impact on the business world. This transcript is edited.

Q: Is helping clients navigate pain management something attorneys increasingly must do?

Randolph: "They will be. This is going to be a progressively increasing problem.

“This whole situation has been gradually getting out of control since about 1996. That’s when Oxycontin hit the market and when somebody thought it would be a great idea for us to release narcotics for something called ‘benign pain,’ which is non-malignant pain —anything, sprains, you name it.

“It lasted for a good while, perhaps 15, 18 years, when the physicians were providing narcotics for any kind of pain. … This is silly. It’s absurd on its face.”

Q: So what has been the result?

Randolph: "Over a period of time, the sale of the narcotic-opiate medications has gradually gone up. It has exploded, as have the hospital admissions for opiate-related health problems and the number of deaths. They have all gone up in a parallel fashion …

“We have seen a gradual slow but steady increase in complications associated with chronic narcotic use and the death rate. We are now losing something like 130 people a day from drug abuse — about 60 percent of those people are due to narcotics.”

Q: What are we seeing in this area, in your practice areas?

Randolph: "In this part of the country, over the last few months, the heroin deaths have increased dramatically. The Hamilton County coroner, Lakshmi Sammarco — a very interesting lady — she has been finding deaths that (stem) from heroin overdoses every day, and it's becoming epidemic.

“They believe what’s happened is someone is slamming this area with fentanyl, which is a very heavy semi-synthetic narcotic … as a test market. And death ensues.

“Many times, police will find somebody who’s dead, and they’ll still have a syringe in their arm. That’s how strong this stuff is.”

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