January 26, 2017

Opioid Use part 1

Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.

If you’ve read the national news or even picked up a local newspaper in the last year, you’ve heard of the opioid drug epidemic overcoming the nation. Do you know who is taking these drugs and how they are getting them? Are they prescription or illegal drugs, or both? Why are these drugs killing people? Do these drugs work for pain control and are there safer alternatives?

While any one reason may not be one hundred percent the cause, we can put a large amount of blame on the drug makers themselves. Oxycontin, Percocet, Duragesic and Fentanyl (a synthetic opioid 50 times stronger than heroin) are the brand names of these opioid drugs. Many believe the makers of these drugs need to be held accountable for this trend, especially since several have been caught lying about the benefits and risks of their drugs.  Heroin is the street drug of choice, but all the others are used and sold illicitly as well.

Let’s start with some statistics. In 2014, more than 28,000 people died from opioid overdoses. In 2013, 16,000 people died from prescribed opioid painkillers. A 2016 study showed a 300% increase in heroin use from 2003 to 2014, reaching 1 million users. Americans use 80% of the world’s opioid drugs. Alabama has the highest opioid prescription rates, 143 prescriptions per 100 people. As a result, more people now die from prescriptions of painkillers than die from street drugs like heroin. “The CDC states that addiction to painkillers is the strongest risk for heroin addiction, and among heroin users, 45% are also addicted to painkillers,” according to Dr. Mercola. How did we get to this point in America?

How have the drug makers caused this epidemic? First, prior to a 2010 remanufacturing, long-acting painkillers like Oxycontin could be snorted or shot. In 2010, the pills were made harder to crush so it was more difficult to inhale or shoot from a needle. Addicts claim this high was better than heroin. This is chemically correct because Oxycontin is nearly identical to heroin.

Second, the drug manufacturers were instrumental in getting the prescription guidelines changed to favor opioids as the first choice for lower back pain and other pain conditions that previously did not qualify for these types of drugs.  They were originally designed for covering the breakthrough pain of cancer patients.

Third, they promoted long term use of opioids for pain control even though there was no evidence that using them long term is safe and effective.  In fact, using them at all has serious effects such as depressing the heart rate and slowing breathing.   Higher doses cause sedation and slowed breathing to the point of stopping altogether, to the point of death.

Fourth, they down played and misinformed doctors and patients about the addictive nature of these drugs. The makers of Oxycontin told doctors and sold their goods by telling people the pain control lasted a full 12 hours. Instead, most people experienced nowhere near that relief, and ended up taking more doses, becoming addicted and then when the drug was removed, incurring painful withdrawal symptoms. The cycle of overuse and abuse continues from that point.

Oxycontin was approved for use in 1996, the maker, Purdue, has hauled in more than $31 billion from its sale. By 2007, Purdue and three of its executives pleaded guilty to criminal charges of misleading regulators, doctors and patients about the drugs addiction and abuse risk. They paid $600 million in fines. Purdue was ordered by the FDA in 2003 to pull its ads due to being “grossly misrepresenting” the drug’s safety profile. Little was done thereafter to rein in their use, and sales continue to soar.

How can the government continue to allow this epidemic to balloon? The FDA claims to be our almighty caretaker overseeing our complete safety in taking “approved” medications. Unfortunately, their response doesn’t punish the drug makers for their criminal deeds. It simply adds profit to their bottom line! Why? Because the response of government has been to focus on treatment of users and the availability of anti-addiction drugs! More drugs to treat their other drugs affects. So the industry that created the problem is now rewarded as the government’s plan to address the epidemic simply puts more money in their pockets.

Drug companies intentionally got people addicted and now they are providing the treatment drugs, paid for by your tax dollars. You’ve heard the recent bill passed right here in Pennsylvania of a standing prescription for the anti-overdose drug Narcan/Naloxone by the top doctor in our state. This means anyone can go to the pharmacy and request Narcan, no questions asked. Why aren’t we doing more to prevent the misuse and overuse of narcotic painkillers, especially since it’s proven they are a gateway drug to heroin?

We will look at the negative health effects of these opioids and other, less deadly, pain treatments in the next article.