By Dr. Scott Rosenthal
In recent years, nothing has shocked me more than the incredible volume of Americans taking opioid pain relievers every day. After learning the actual numbers, my shock has turned to anger and the need to start a revolution! Yes, these pain killers can be invaluable in certain cases and have a place in the medical tool box. But, they are killing far more than pain and now have outpaced automobile accidents as a cause of death.
Opioids are prescription medications. Using their generic names, you can identify them as fentanyl, hydrocodone, hydromorphone, morphine and oxycodone. In 2013, 16,235 Americans were killed from opioid pharmaceutical overdose. Prescription opioid abuse cost roughly $55.7 billion in 2007. (1)
Please keep reading! I will get to the actual numbers that made my neck hairs stand on end. First, I want to cover a few more must-know facts!
Opioids are the most common treatment in medicine for low back pain. (2) They are prescribed to roughly 50 percent of back pain sufferers. Researchers recently attending the National Institutes of Health (NIH) conference on “The Role of Opioids in the Treatment of Chronic Pain” believe that the use of opioids for low back pain should be reconsidered. This recommendation is based on the following, as stated in the January issue of the medical journal, The Back Letter:
1.“There is no evidence that opioids are effective for long-term treatment of chronic pain”
2.“Opioid therapy is causing grave harm to patients and to society”
3.“Opioids are impeding the effective treatment of low back pain” (3)
As a highly effective, evidence-based approach for back pain, chiropractic care can prevent the need for a prescription. This drug-free approach brings welcomed relief without the potential harm caused by opioid prescription use.
Opioids are also the most commonly diverted controlled prescription drugs. Meaning, they are used more often for non-medical or recreational reasons than any other prescription out there. (4) They are costly and often lead to the use of a far cheaper street drug also ravaging communities across America: Heroin. Also in the opioid family, Heroin has been described as the illegal cousin of the common prescriptions. A report from National Public Radio (NPR) titled “Spike In Heroin Use Can Be Traced To Prescription Pads,” illustrates other facets and the enormity of the problem. Imagine the face of the interviewer after she heard one of her sources, Dr. Andrew Kolodny, chief medical officer for the Phoenix House Foundation and president of Physicians for Responsible Opioid Prescribing, state:
“When you talk to people who use heroin today, almost all of them will tell you that their opioid addiction began with exposure to painkillers.” (5)
Being so highly addictive, the problem of recreational opioid use now fills our schools. A state Department of Health survey of 81 school nurses in Rhode Island found an alarming rate of 911 calls because students were suspected of substance abuse or an overdose. They were calling to have the opioid overdose rescue drug, called Narcan, available in schools. (6)
The bad news is that prescriptions for opioids increased from 75.5 million 1991 to 209.5 million in 2010. (7) The better news is that this trend has plateaued or decreased between 2011 and 2013. (8) However, the numbers of legal users with a prescription is nothing short of mind-blowing.
As promised, below are the numbers that set this easy-going doctor on edge! The Centers for Disease Control and Prevention conducted an analysis of 2012. They found:
Nationwide, on average, 82.5 out of every 100 Americans had a prescription written for opioid painkillers in 2012.
According to CDC Director, Dr. Thomas Frieden, "This is an epidemic that was largely caused by improper prescribing practices." The numbers varied state-by-state, but it is not believed this is due to people hurting more in one locale than another.
You may be surprised to hear that California had one of the lowest rates of only 57 prescriptions per 100 people. Eleven states average one opioid prescription for every single resident. Alabama, with the state motto of "We Dare Defend our Rights," may want to reconsider their right for prescriptions as they led the country with 143 pain pill prescriptions for every 100 people. Before you feel lucky not to live in the south, the next statistic may be a tough pill to swallow: 90.8 out of a 100 Delawareans had a prescription for painkillers in 2012. If you live just over the line, Pennsylvania came in at 88.2. Maryland and New Jersey were lower, but still had alarmingly high rates. (9)
What to do? Before waiting for decades of prescribing practices to change and new laws to be passed, take action! Try safe alternatives such as the drug-free approaches offered in chiropractic, massage therapy, acupuncture or one of the many forms of bodywork. These healing arts really work and help millions experience pain relief while avoiding the need for pharmaceuticals. Ask your doctor if there are non-opioid alternatives. Save the opioid as a very last resort. If they are needed, try to get off them as soon as possible. Never share and dispose of your unused prescriptions. If you suspect that you, a loved one or friend is becoming or became addicted, get help immediately!
Opioid prescription and opioid recreational use has become one of America’s greatest problems. The astonishing rates of use demonstrate the need for immediate change. By seeing an opioid more as a loaded gun or drug store Heroin rather than an innocent little pill, lives can be saved. Will you join the revolution?
2. Univ. Texas Health Science Center
3. BackLetter: January 2015 - Volume 30 - Issue 1 - p 4
4. Drug Enforcement Administration
7. National Institute on Drug Abuse