Despite epidemic, doctor says opioids also help patients

Opioid addiction is an epidemic gripping the nation, leading to thousands of overdose deaths annually. But Dr. Kevin Zacharoff, an anesthesiologist with more than 25 years of experience in pain medicine, says opioids can also provide much-needed relief to many patients.

There are tens of thousands of people for whom opioids are the best form of treatment, Zacharoff told medical professionals and Long Islanders at a symposium at Stony Brook Medicine on Friday.

Rather than not prescribe opioids at all, Zacharoff believes there needs to be more discussion among health professionals and in medical schools about the risks and benefits of opioids as pain treatment. Currently, only about 4 percent of all medical schools in the country have curriculums dedicated to pain management and addiction, he said. Stony Brook is in the process of developing a curriculum for fourth-year medical students to be implemented next year on those topics, he said.

“The only thing that really concerns me is that we don’t throw the baby away with the bath water,” he said. “Opioids have been around for 4,000 years.”

Zacharoff, a Southampton resident who travels around the country lecturing on pain management and opioids, was the keynote speaker Friday at Stony Brook Medicine’s third annual Medical Ethics Symposium.

The focus this year was on how those who work in pain management are addressing the opioid addiction, over-prescription and overdoses that have plagued Long Island and much of the country. The all-day symposium included a handful of panels and featured more than a dozen Stony Brook Medicine medical professionals who are influencing care.

The majority of the more than 140 people who attended the event work in the medical community. A fourth were everyday Long Islanders, said Kali Chan, the hospital’s director of medicine media relations.

Zacharoff is a clinical professor at Stony Brook’s School of Medicine and a member of the Anesthetic and Analgesic Drug Products Advisory Committee to the U.S. Food and Drug Administration.

“I always used to say when an opioid is being provided for a patient, it’s between the patient and the health care provider,” Zacharoff said during his presentation.

These days, however, that isn’t always the case. In recent years, as the epidemic has worsened, Zacharoff said the government has introduced limits on the manufacturing of opioids. Also, with more media attention on the opioid crisis nationally and locally, there has been increased scrutiny of doctors prescribing the drugs, he said.

Pediatrician Lisa Wilks-Gallo agrees.

Though she says she never prescribes opioids unless they’re warranted, she said she still faces opposition from parents about 50 percent of the time.

Marco Palmieri, the Stony Brook Center for Pain Management’s medical director, says he has also gotten increased pushback from patients.

Nonetheless, he said his goal has remained the same.

Opioids are just one small portion of his practice, he said. Psychological and interventional-based therapies, such as injections, can also be ideal in pain management.

“I think the big key is multi-disciplinary management,” Palmieri said. “Trying to optimize each individual treatment utilizing interventional techniques.”