When a family physician moved to a new rural community, she was unprepared for the constant flow of patients seeking prescriptions for opioids. In this essay, she recounts her patients' denial and anger and her own feelings of frustration and burnout as she tried to balance good medical care with the wants of her patients. A turning point came when she received training in medication-assisted treatment for opioid addiction. Her role transformed from a "villain" trying to prescribe non-opioid therapies, to a coach. The decision to provide her patients and community with medication-assisted treatment, the author states, led to her professional healing. She calls on health care professionals to challenge their prescribing habits, recognize opioid addiction, and support one another in providing treatment.
Denial: The Greatest Barrier to the Opioid Epidemic
Nicole Gastala, MD, Marshalltown, Iowa