In VCU Health’s ambulatory center downtown, there is a picture that looks, from a distance, like a tree. “But if you get closer,” said A. Omar Abubaker, talking to Katie O’Connor of the Richmond Times-Dispatch, “you see it’s actually a collection of faces and images. To me, the opioid epidemic, both to clinicians and to the public, it’s from a distance. If I say, ‘Opioid epidemic,’ the first thing you think about is the graphs, the number of people that died, the statistics. For those of us that are affected, it’s about faces, memories, sons and daughters.”
A personal tragedy
Abubaker is the chairman of Virginia Commonwealth University’s School of Dentistry’s Department of Oral and Maxillofacial Surgery. He has been with the school for more than 25 years and, for most of his career, he was like every other doctor when it came to prescribing opioids: it was a habit.
But all that changed in September 2014, when his son died of an overdose of heroin. Just like any parent that has lost a child, there are still pieces of his son’s death that Abubaker cannot talk about.
Pieces that, even when he tries to gather himself and face them when he is alone, haven’t gotten easier. The experience radically shifted not just Abubaker’s personal life, but his professional one, too.
Suddenly, he wasn’t seeing the opioid epidemic in terms of charts and graphs and startlingly large annual death numbers, including 1,133 in Virginia last year. He was seeing his 21-year-old son.
Mr. Abubaker knows as well as anyone how the prescribing practices of providers have fed the opioid epidemic. He isn’t certain what caused his son, Adam, to use heroin. But he does know he was probably overprescribed opioid painkillers following surgeries when he was a teenager, which are the same drugs that Abubaker used to frequently prescribe.
Both in medicine and dentistry, the Hippocratic Oath says, ‘Do no harm.’ In fact, ‘Do no harm,’ comes even before, ‘Do good.’ So the ‘Do no harm’ part comes down to how we stop prescribing medications as much as we have in the past.
And the ‘Do good,’ is to see if our society – or any of us – can do something to make this better, to help the families affected.
According to the article, providers have already started changing their prescribing practices, which has resulted in federal data showing a dip in the most popular painkillers, beginning around 2013 in Virginia. The state is also beginning to see fewer prescription painkiller deaths, too. In the first quarter of this year, 113 people died from prescription opioids, which is down from 124 who had died at the same time in 2016.
But people cut off from the painkillers they grew addicted to have turned to illegal versions of the same basic drug in the form of heroin and fentanyl, offsetting any progress made on the prescription side. There were 127 heroin overdose fatalities so far this year, compared with 110 last year. The deadlier drug fentanyl is killing even more people – 190 so far this year, compared with 145 this time last year.
This is the only disease created by doctors, and it could be fixed by doctors. – Abubaker
Educating others on the dangers of prescription meds
Following the death of Adam, Abubaker spent a year educating himself about addiction, receiving a graduate certificate in international addiction studies.
I educated myself, because I didn’t want to be talking about it emotionally as a parent. As an educator, I have to talk intelligently and scientifically.
According to Abubaker, dentists in the community still overprescribe opioids. But he hopes that more dentists are learning about the harm of such prescribing practices, which is why he speaks regularly to community dentists about how they should change their prescribing practices.
I used to ask people: What do you do for pain? They’d say, ‘Percocet,’ and I’d say, ‘OK, no problem.’ Never, ‘Is that too strong for you?’ And that’s the pattern. Everybody that gets a tooth pulled – whether it’s one tooth or 10 teeth or all teeth – they get a prescription.
And I don’t want to say I was careless, but I was like 95 percent of doctors and oral surgeons.