There is a serious crisis and it’s been sweeping across America for decades. Overdoseand deathdue to pain-relieving drugs called opioids are becoming all too familiar. Opioids are a class of drugs found in the poppy plant. These drugs include, hydrocodone (Vicodin) codeine, morphine, oxycodone(oxytocin), tramadol (Ultram), fentanyl and even heroin. These drugs, with the exception of heroin, are prescribed by a physician for acute pain and should only be taken for a short period of time.  However, these drugs are very addictive, leading some individuals to overdose and/or death.

From 1991 to 2011 there was a near tripling of opioid prescriptions dispensed by U.S. pharmacies from 76 million to 219 million prescriptions.1  In parallel with this increase, there was also a near tripling of opioid related deaths over the same time period.1 Recent studies show that over the last two decades, this number has quadrupled and the highest rates are now seen in eight states including:Connecticut, Illinois, Indiana, Massachusetts, Maryland, Maine, New Hampshire and Ohio.2

Analysis of data from the U.S. Census and the National Center for Health Statistics suggests the opioid overdose epidemic has evolved as three waves. The first wave took place from the 1990’s until about 2010, and was associated with prescription opioid painkillers (such as oxytocin). The second wave, from 2010 until recently, was associated with a large increase of heroine related deaths. The third and current wave, which began around 2013, involves rapid increase in deaths associated with synthetic opioids, such as Tramadol (Ultram and Fentanyl. ²

What started as a problem among the rural poor in America has now spread across the nation and into the Hollywood spotlight.3 “Addiction to opioids in America crosses all cultural and economic barriers,” said Dr. Andrew Kowal, Director of The Pain Center at the Lahey Clinic in Burlington, Massachusetts. “You could be living in the hills of West Virginia, or an actor making $10 million on a movie.”Kowal says that between 1997 and 2005, methadone

prescriptions shot up by 1,000 percent, oxycodone prescriptions (slow acting OxyContin) went up 600 percent, and prescriptions for generic Vicodin increased 200 percent. Anyone can become dependent on prescription painkillers, but addiction often begins with emotional dependence. “People start self-treating their anxiety, depression or loneliness,”Kowal said.3

            Recently there have been several celebrities that have overdosed on opioids.  Music icon Prince, Tom Petty and American Rapper Mac Miller.4In 2014, Rapper Macklemore, a recovering addict, wrote a song called “Drug Dealer.” The lyrics state, “…my drug dealer was a doctor,” and artist Ariana Deboo sings, “I think he trying to kill me. Tried to kill me.”

The lyrics are in reference to doctors giving out opioid prescriptions.4

The opioid crisis has been widely blamed on doctors writing out massive opioid prescriptions to their patients.5 From 1997 to 2006, the number of prescriptions for opioid pain pills increased dramatically: prescription sales of hydrocodone went up 224 percent, while oxycodone sales rose 732 percent. Pharmaceutical companies are also taking the blame.In the mid to late 1990s, the pharmaceutical industry began to promote opioids as safe for the long treatment of chronic pain. Among the widely used opioids  are hydrocodone, (Vicodin), OxyContin and Percocet. Other potent opioids include fentanyl and methadone.

The pharmaceutical industry became flush with cash:from 1995 to 2002, drug manufacturing was the nation’s most profitable industry. These companies employed a large legion of lobbyists, with more than two for each member of Congress by 2004, allowing them to quell attempts to regulate their prices and promotional practices.  In December of 2012, Dr. Russell Portenoy, a prominent pain-care specialist who drove the movement in the 1900s to help people with chronic pain, says he was wrong to have used the one percent addiction-risk figure in lectures because it wasn’t relevant for patients with chronic non-cancer pain.“Data about the effectiveness of opioids does not exist,” he tells The Wall Street Journal.5 In May of 2007, Purdue Pharmacy, the makers of OxyContin, paid a $634.5 million fine for misleading doctors and patients about the risk of addiction. Three of its top executives plead guilty, but none served jail time.5

            In January 2019, Massachusetts  and hundreds of other government entities sued opioid manufactures, including Purdue, as well as companies that distributed the drugs, claiming that they should pay for the damage the pills wrought.6

 On February 1, 2018, CVS Pharmacy was one of the first national retail chains to restrict how many pain pills doctors can give patients.7 CVS Pharmacy will limit opioid prescription to a seven-day supply for certain conditions. When filling a prescription for opioid pills, pharmacists will also be required to talk to patients about the risks of addiction, secure storage of medications in the home and proper disposal according to the retail pharmacy.7 The CVS announcement comes on the heels of a special publication released by the National Academy of Medicine, “First, Do No Harm, which calls on the leadership and action of doctors to reverse the “course of preventable harm and suffering from prescription opioids”. “Simply restricting access to opioids without offering alternative pain treatments may have limited efficacy in reducing prescription opioid abuse” said representatives from NIDA. But the move is a major part of the multidimensional solution needed to conquer opioid abuse and a long-awaited step in the right direction.7

While CVS is leading in the right direction, doctors must come up with an alternative plan for chronic pain. I suffered chronic neck pain last year. I went to my doctor and the first thing he gave me was a muscle relaxer for the pain. Those pills were way too strong for me, and I could barely stay awake during the day. I took it upon myself to find an alternative measure to relive my pain. I went to a chiropractor. I was skeptical at first, but after the first few visits,I could feel the pain ease up on my neck. I finished my course of treatment and the crippling pain I had is gone.

I know several people who went to their doctor and took opioids for their chronic pain. Unfortunately, some of them became addicted to the drugs and some tragically died. One of these friends was a young adult, who didn’t get help because of the shame and stigma associated with being an addict.  Others are fighting the horrifying addiction of these pills today. My prayers go out to the families who have lost their children, parents, friends and other loved ones to addiction. I pray for all the people and my friends who are battling this addiction right now, and I hope they discover the courage and strength to get help.

The followingtreatment centers may be a helpful resource:

~ Sharon

©2019 Do No Harm Foundation

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