The Opioid Epidemic: Who's to Blame?

Opioid Epidemic Blame - Freedom From Addiction

A study published earlier this month showed an alarmingly steady increase in the deaths of middle-aged white Americans in comparison to a decreasing death rate in all other age and ethic groups with middle-aged people in other developed countries. With other middle-aged groups thriving, one must stop and ask what, then is killing so many white Americans? Sadly, the answer is addiction. Drug and alcohol poisonings and suicide are behind the rising demise of so many. Sadly, many of these addictions are to opioid painkillers, like OxyContin, which start as pain treatments prescribed by physicians. 

An article in the New York Times reveals shocking statistics that prescription opioid deaths "in the United States increased more than fourfold between 1999 and 2010, dwarfing the combined mortality from heroin and cocaine." In 2013 alone, the article goes on to say "Opioids were involved in 37 percent of all fatal drug overdoses." How has prescription drug mis-use gotten so far out of hand? In the past, opioid analgesics were traditionally used to treat pain for terminal diseases, like cancer. In the short-term they were used to treat patients recovering from surgery. But in the '90s, the mindset changed and opioids were used in excess to treat long-term pain problems, like back pain, sciatica and musculoskeletal problems. Drug companies created "new and powerful opioids, like OxyContin, an extended-release form of oxycodone and encouraged doctors to 'be proactive with pain and treat it aggressively.'" What many didn't realize was how the proactive and aggressive treatment could hook the patient on the drug and create an addict. Shockingly, according to the article, "Primary care physicians, who generally do not have any particular expertise or training in pain management, prescribed far more opioids overall than pain specialists. For example, in 2012, 18 percent of all prescriptions for opioid analgesics were written by family practitioners, and 15 percent by internists, compared to five percent of pain specialists." Those prescriptions could possibly be responsible for 39 percent of all emergency room visits for non-medical drug use, according to the article. What's even more disturbing is that there isn't proof that long-term opioid use is even effective for nonmalignant pain. In fact, there is "strong evidence that non-steroidal, anti-inflammatory drugs (Nsaids), like Motrin, and other analgesics, like Tylenol, are actually safer and more effective for many painful conditions than opioid painkillers." Because these are prescribed drugs, one has to stop and wonder, how are doctors weighing in on these shocking results? Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, recently told Cape Cod Times that doctors had been tricked into prescribing opioids. "The medical community was duped by aggressive and misleading marketing about the safety of opioids starting in 1996 by the pharmaceutical industry. This led to rampant over prescribing of oxycodone and hydrocodone. These two chemical alterations of opium are so similar to heroin they should be called heroin pills," he says. But doctors didn't know. As drugs like OxyContin were prescribed more and more, the number of overdoses began to rise. But drug companies assured doctors the drugs were not as addictive as previously thought. He goes on to say, "Purdue Pharma called doctors' opioid fears, 'barriers to compassionate pain care. Their message was so compelling: we're letting our patients suffer needlessly." Now we're living in an epidemic of opioid misuse. Currently, the Food and Drug Administration is taking steps to provide doctors with training and education about safety and adding label warnings to drugs. But the death toll continues to rise. It begs the question, where do we go and what do we do to make this stop? The New York Times article suggests "Educating and training our medical students and residents about the risks and limited benefits of opioids in treating pain. All medical professional organizations should back mandated education about safe opioid treatment as a prerequisite for licensure and prescribing. At present, the American Academy of Family Physicians opposes such a measure because it could limit patient access to pain treatment with opioids, which I think is misguided. Don't we want family doctors, who are significant prescribers of opioids, to learn about their limitations and dangers?" Combining that type of education and treatment to those who are already addicted could help lead to a cure.

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