Iatrogenesis- Blame the Doctors for the Opioid Epidemic?

Iatrogenesis means "brought forth by healers" and is used to describe a negative outcome as a result of medical intervention.  Some simple examples are negative drug interactions, operating on the wrong limb or organ, etc. An iatrogenic effect is not always harmful. A scar from surgery is often referred to as iatrogenic, even though the benefits of the surgery likely outweigh the negative impacts of the scar.

Why bring up such a word in the context of MATClinics?  It is becoming more and more common to hear politicians and even physicians put the blame for the current opioid epidemic squarely at the feet of the medical profession.  

Dr. Jane Ballantine outlines two initial steps to address the opioid crisis:

“To fix the opioid epidemic, we need two main
courses of action. One is to change the culture
in terms of the role of opiates in the treatment
of chronic pain; the other is to
accept that we produced the iatrogenic disaster. ”

— Chen, Ballantine & Meghna, Health Care Transformation, March 2017

Its becoming more common to hear physicians start to take responsibility for their part in the opioid epidemic and is likely a critical step in beginning to control the overprescription of opioids.

It may be starting to work.  Last week Cigna reported that prescriptions of opioids in its network has declined over eleven percent in the last year.  

Iatrogenesis will be with us as long as the medical profession tries to improve.  History is littered with examples, and there is no reason to believe that the future will be any different.  Well meaning professionals are susceptible to overconfidence and belief that they have found cures without consequence. The opioid epidemic is one such example. Let's hope the next systemic iatrogenic effects are less harmful than this one.

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