Opioid Crisis: Good intentions gone wrong

By Gary McCollum

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We hear daily about the “Opioid Crisis” in America. We hear about the staggering number of daily deaths from opioid overdose.

Beginning around 1980, one of the more significant trends in pain pharmacology was the increased use of opioids for chronic non-cancer pain.

People would have a minor surgery, complain of chronic pain or go to the dentist for a tooth removal and be given a large quantity of pain medication. Pharmaceutical companies were aggressively selling these to physicians. In 2007, in United States of America v. The Purdue Frederick Company, Inc., Purdue and its top executives pleaded guilty to charges that it misled doctors and patients about the addictive properties of OxyContin and misbranded the product as “abuse resistant.”

Since 2000, the number of overdose deaths from drugs in the U.S. has risen more than 138%. The Centers for Disease Control and Prevention termed this a “deadly epidemic” of painkiller abuse.

The over prescription of painkillers has created a severe issue across the United States. In response the Government has increased regulations on doctors and patients to prevent over prescribing and patients from doctor shopping. The Boom-A-Rang effect is now beginning to show up.

Many primary care physicians, in fear of government regulation, interference in their practices and law suits stopped writing prescriptions. Many of them, overnight. The result of this is many functional (although addicted), successful people from all walks of life no longer had access to the drugs that were needed and in some cases abused.

These patients were left to deal with their addiction and/or pain without any form of relief. Lawyers, Mechanics, Bank Tellers, etc. were now labeled as drug abusers.

Opioid pain medication is very similar to heroin and the withdrawal from this drug can present itself as a cold or flu, it will make the individual feel extreme aches and pain, experience fever and in some severe cases lead to death. To get help, they had to enter a rehabilitation program (admitting they were an addict), tough it out or self-medicate using other substances such as alcohol, marijuana, purchase pain medication off the street, or go to the next extreme, heroin. Opioid pain medications and heroin are both derived from Opium.

These individuals that felt forced, either by their addiction or their actual need of relief from chronic pain, that chose to ‘self-medicate’ are now labeled as criminals, junkies, etc.

But why hadn’t we heard about the opioid crisis until recently? Heroin has for many years been a fringe drug, a drug that wasn’t at the top of the most commonly abused. It had been in decline since approximately the mid 70’s. Now, however, heroin is back. It is back in a major way. By curbing the pain medication abuse, there has been a severe increase in demand for alternatives, thus inadvertently creating a market for heroin and fentanyl.

In 2016 the number of heroin users in the United States jumped from 404,000 in 2002 to 948,000 in 2016, a 135% increase according to the most recent government numbers. This year drug overdose deaths are expected to reach an all-time high of 71,600. By comparison the US military saw 58,220 fatal casualties during the Vietnam war.

Government crackdown is reducing the amount of pain medication overdoses, but the boom-a-rang effect means that heroin and fentanyl overdoses are expected to double.

There are other victims to the government crackdown as medical legislation could make life more difficult for people living with chronic pain, people with severe back pain, fibromyalgia, arthritis, Ehlers-Danlos Syndrome, etc. These patients are sometimes forced to feel like they are drug abusers by physicians, their staff, pharmacies and society in general.

To win the war on opiates we need to educate physicians. Big pharmaceutical companies and doctors created the addiction problem. They both need to aid in addressing their patients’ needs by providing an alternative to help them taper off the drugs, such as buprenorphine or methadone. To do so without demeaning them, belittling them or making them feel less of a person.

I’ve had four friends over the past ten years that have broken many hearts due to the opioid issue. Two overdosed, one committed suicide and the other spent a few years in prison losing his career, home, car and most devastatingly his family.

We need to educate society. We need to see a person that has dreams, family, and wants to be a part of society. We need to address the underlying problems which drive a person to abuse drugs and which encourage drugs as a solution to all life’s problems. Effective education and prevention are the answer to the opioid crisis.

3 thoughts on “Opioid Crisis: Good intentions gone wrong

  1. People seem to always have the answers to problems that they know nothing about. It’s simple really, those addicts are just too weak when it comes to their will power. Or it would be real easy just to walk a mile a day and eat all the proper vegetables, meditate for 30 minutes twice a day, oh don’t forget to use the latest ASMR or sounds of the ocean to soothe the pain away. Yep, proper exercise, meditation and a proper diet will do the trick, no more pain after that. I say those who think like this are ignorant of what pain truly is. They surely have never experienced it for them selves. When there is nothing else that surgeons or physical therapist can do and when the nerve blocks have stopped working and burning the nerve endings have now failed, I’m sure taking a good walk and some healthy food will make it all better right after the evening meditation session. Yep, I agree, it’s all really sad. Those poor suckers that the big drug companies and doctors have taken advantage of just to make boat loads of cash. If only those doctors cared about the people they treat, they would not offer any form of relief beyond massages, dietary requirements and of course the all powerful pain relief regiment of exercise and eating right. Agreed? …Sarcasm off…

    Pain that never stops, 24-7, day after day, year after year, simply can not be understood by anyone that has not experienced life with it. What it does to families, relationships and careers is devastating. When all the strongest pain medication offers is to numb the pain enough to keep going there is no pleasure in life. I am one of “those people” but I have not abdicated my responsibilities to anyone. I think it’s a huge mistake to paint everyone that uses this type medication with the same brush. The article itself contains some good points but it is a very complex issue. My fear is that congress will have a knee jerk reaction to the political pressure and over regulate like they usually do. There are people out there that truly need the medication and do use them as prescribed. Not everyone abuses these drugs, there are many others, like me, who would not be able to live with the non relenting pain and no relief available. I have had 5 back surgeries with nerve damage that causes severe nerve pain continually. I finally had to retire on disability because I could no longer walk, stand or sit longer than 10 or 15 minutes.
    I have had the nerve blocks, the burning of the nerves, the surgeries and everything possible but now there are no more options left but drugs.

    There are doctors that specialize in pain management and treatment of chronic pain. These specialists are the best way to control the dispensing of pain medication along with other procedures and treatments that are available in their field of study. Along with regular drug testing to verify the proper use of the medication prescribed and to make sure no other drugs or alcohol is being consumed by the patient. The most common drug that gets people started down the road of addiction is Hydrocodone also known as Loritab, Vicodin and other names. This has been the go to painkiller for family doctors, surgeons and dentist for many years to treat temporary pain from surgeries and dental procedures. This really needs to stop and by doing so it may help reduce the number of those that get hooked. There must be another way of treating the temporary pain other than with opioids. Maybe it is eating your greens and broccoli. LOL

  2. Follow the dollar bill – this is about making money, not about patient wellbeing. Drs are trained to dispense pharmaceuticals, we are all nails and Drs are equipped with a hammer. Pharmaceutical companies and physicians denigrate other forms of pain control that are not taught in medical schools – massage, meditation, etc. On the other hand, patients expect immediate results and abdicate their responsibilities for their own health and well-being. Most people would rather pop a pill than follow a pain relieving regiment of exercise and eating right. It’s really sad.

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