It’s a Reason article, and so it has a political motivation, but it also brings cites with it. Notably this one:
It seems to me that we have a very real recreational opioid abuse problem, but that attacking the problem at the medical end is pretty stupid. People aren’t dying because doctors prescribe too many painkillers, people die because painkillers are a recreational drug which only becomes really dangerous when combined with other drugs or alcohol.
It isn’t just combining opioids with CNS depressants that is deadly, combining them with stimulants is deadly too. The reason is stimulants mask the impact the depressants are having, which cause you to take a higher dose of depressants. Since cocaine has a half life of 1 hour while morphine has a half life of 6, you may take a ton of heroin thinking you can handle it because the cocaine is keeping you awake, but once the coke wears off you OD and die.
I’m currently reading Duff McKagans biography, he talks about how when he discovered mixing alcohol with cocaine, he was able to drink 2-3 times as much alcohol as normal. The cocaine kept his body awake with all the extra alcohol. But if the coke wears off first, then you just have 2-3x more alcohol in your system than normal and nothing to balance it out.
But doesn’t that mean that worrying about prescriptions is barking up the wrong tree? Isn’t this primarily a street drug issue, just like meth or crack?
I don’t know the details, but I’m cynical enough to not think politicians or the DEA have the well being of the public in mind when they propose policy regarding drugs.
I do know some chronic pain patients who have been forced to resort to heroin because they can’t get their legal pain pills anymore.
No. People often become addicted to legitimate prescriptions, and when they can no longer access the drug, or afford it, they turn to heroin (street drugs).
Are they addicted because they use it recreationally, or because they have this medical problem known as PAIN?
Also, while addiction is never a good thing, if it’s purely an addiction based on medical need, the cites show that the risk is still very low for people who use these drugs as directed.
It often starts with the pain, but then turns into an addiction after the pain is gone.
I mean, it’s not like doctors are prescribing these things just to get people addicted to them.
It’s hard to believe this is the whole story with these people. If someone has a legitimate, ongoing pain issue, while they may have to jump thru additional hoops, it shouldn’t be impossible to get the medicine they need.
OTOH, patients who began as legitimate pain patients, may become addicted and when their “legitimate” source dries up they turn to heroin.
Isn’t it the responsibility of medical professionals to properly wean people off these drugs? I would think that any doctor that just cut someone off would be committing malpractice. One doesn’t just stop using opioids cold turkey.
It’s the patient’s responsibility to properly carry out the doctor’s instructions re titration. No doctor can ensure a patient’s compliance. If an addiction has already taken root in the patient, weaning off is not an option (in their minds).
According to the article though, even that’s not a huge risk. Less than 1% turn into addicts.
It never hurts to remind patients and doctors of the risks of that course of treatment, but what the government is doing to put roadblocks in the way of access to medicine does not seem to be likely to help and will only hurt legitimate patients.
Taking a narcotic painkiller for an extended time, for any reason, will result in physical dependence and in many cases, addiction as well. The myth that you don’t get high from painkillers if you are taking them for pain is just that, a myth.
1% of how many people?
259 million prescriptions. So we’re still talking about millions of people.
So we harm the 99% to help the 1%?
A couple of years ago I was prescribed hydrocodone after I got oral surgery.
I still have the bottle. It’s almost completely full. Why? Because each dose made me nauseous. I decided I would rather deal with the pain.
I’m guessing the 259 million prescriptions includes a lot of people like me. Folks in pain but not serious pain. When it’s not that bad and the pain is going to resolve itself after a week anyway, of course you aren’t going to get people popping pills. I’m guessing the likelihood of addiction steeply increases when the pain is chronic and severe. If we were to use the number of patients with severe and chronic pain as the denominator, what percentage would be classified as “addicts” then? I’m guessing a whole lot more than 1%.
Just for interesting reading: Why the opiod epidemic has hit West Virginia so hard.
Again, those with legitimate pain issues may have to jump thru additional hoops to get their meds but it’s certainly not impossible. I’m a perfect example myself; I’ve been a chronic pain patient for almost a decade and I have not been harmed by any of the law changes.
My friend’s 25 year old brother (a nursing student) was on opioids for back pain and became addicted, went to rehab, learned about heroin and where to get it, and 3 days out of rehab died of a heroin overdose. The threat is real.
Jumping through hoops is fine. Taking the hoops away entirely is not. My wife is prescribed low dose fentanyl patches. Most drug stores don’t have them in stock. So I asked them at first, back when I was naive, “Okay, can you order them?” “Sure!” they sometimes said. “Come back Friday.” I did. And then they explained that the order was denied. For what reason? Did the pharmacy issue painkillers without a prescription? Nope, nothing that blatant.