There were an estimated 254 million opioid prescriptions written in 2010 – enough to keep all of America numb around the clock. I recently read two very interesting articles profiling Pharma companies in the growing world of pain medication derived from opioids. The first article, “Painful Medicine” was in Fortune magazine, the second was done by the Associated Press. The Physicians for Responsible Opioid Prescribing report that 25% of those on opiod medication meet criteria for addiction. I suspect this number is too low because physicians often lack proper training in recognizing symptoms of addiction.
What is an opioid or opiate? It’s a broad category of drugs that are best known as painkillers. These are naturally derived from the poppy plant and include opium, codeine and morphine, or are synthetic and semi-synthetics variants of those molecules; Hydrocodone and Oxycodone are the most abused opiates.
Opiates block pain but also unleash intense feelings of well-being and can create physical dependence. The withdrawal symptoms are also intense, with users complaining of cramps, diarrhea, muddled thinking, and nausea and vomiting.
In 2008, it was suspected that over 15,000 Americans died from opioid overdoses, triple the rate from 1999.
Why are the numbers of these prescriptions on the rise? Are we in that much more pain? America’s first thought for pain is medication. Some can take it and quit; however, the more people use pain medication, the more they crave to use, thus increasing tolerance. Secondly, it is easier to justify taking a pill than asking for heroin, which has similar characteristics. Detox symptoms can be so severe that people tend to put off wanting to stop the medication. Since the drug is prescribed by doctors, we justify it is okay to use; however, it can create a demon inside of us that we have no idea how to control.
The dark side of the addiction to these pain killers include: murders, pharmacy robberies and millions of dollars lost by hospitals that must treat overdose victims. For example, emergency room visits related to Hydrocodone abuse have shot up from 19,221 in 2000 to 86,258 in 2009, according to data compiled by the Drug Enforcement Administration.
When I asked our Chief Medical Officer Dr. Jason Powers to comment, he said he was not surprised by how much more the older, non-time release formulations go for on the streets. Addicts will not spend a lot unless they get a good high. Likewise the street value for Suboxone is not as high as Subutex; the latter can be directly injected while the former has a built in deterrent for diversion and abuse
The Associated Press reports that drug companies are working to develop a pure, more powerful version of the nation's second most-abused medicine: Hydrocodone. The new pills contain this highly addictive painkiller, packing up to 10 times the amount of the drug as existing medications, such as Vicodin. If approved, it would mark the first time patients could legally buy pure Hydrocodone. Existing products combine the drug with non-addictive painkillers such as acetaminophen.
Pain medicine is a slippery slope for most. Both doctors and patients should give serious consideration to using holistic alternatives if possible, including meditation, physical therapy, nutrition and fitness prior to starting these medications.
We suspect 10% of Americans are addicted in general, yet there is a much higher percentage of those who are on pain killers. A carefully planned medical detoxification is necessary if someone is addicted to pain killers. Physicians who are trained in detox are the best to make sure the process is safe. Then a complete evaluation is needed to determine the true extent of the pain and what is needed to provide relief.