Stop Blaming Prescription Opioids

Opioid pill

Opioid pill
Last year I angered a lot of my friends when I criticized politicians and the media for misstating and miscommunicating the nature of the so-called opioid epidemic. My concerns were two-fold. First was the tendency to lump legal analgesics with heroin when citing statistics. Second was an overreaction by Governor Cooper and others in handing down restrictive regulations on the sale and use of legal opioid medicines on which millions of patients rely for much-needed pain relief. Now comes a third cause of concern: the blame game.

Last week Forsyth County joined a jillion other localities in deciding to sue the manufacturers of opioid medicines. Their reason? Opioid abuse has caused the County to spend non-budgeted funds on emergency and social services, and the lawsuit seeks to recoup those costs. Translation? Companies who make pain pills are to blame for people abusing or misusing those pills. What’s next, blaming the pills themselves for being ingested? Actually, yes. A few days after the Forsyth County litigation was reported, a convicted killer in Ohio announced that pain pills led him to murder two people. That’s right, the man is appealing his death sentence on the grounds that many years ago, after suffering a work-related injury, he took pain pills, which, years later, caused him to brutally stab his wife and another man.

The absurdity of these kinds of blame puts me in mind of the NRA’s mantra about guns, which was eloquently re-stated by Elise Patkotak who, writing for the Alaska Dispatch in 2012, said, “Drugs don’t kill people—people kill people (and themselves) by misusing the drugs. As with guns, drugs are morally neutral until used by a person in a specific manner that renders them, for that moment, good or bad.”

That same year Dr. Steven Passik, a professor of psychiatry and anesthesiology at Vanderbilt University, came to a similar conclusion when he suggested that it is wrong to blame drugs for addiction. Speaking with the Center for Health Journal, Passik said, “This is the first mistake of opioidphobes.”

So if prescription opioids are not inherently bad, then who or what is to blame for addiction? Again, politicians point the finger at manufacturers and the doctors who prescribe their product. But that reasoning sets up a false narrative. Yes it’s true that there have been unscrupulous companies who purposely flooded the market with pain pills for profit. In 1996, for example, Purdue Pharma introduced oxycontin and assured physicians that the drugs weren’t addictive. Purdue lied and was later punished. And yes there were doctors and pharmacists who created a cottage industry around bulk sale of pain pills. But the Feds cracked down on that scam and today, according to Dr. Caleb Alexander, director of the Center for Drug Safety at Johns Hopkins, doctor shoppers make up less than one percent of all opioid users.

So if manufacturers, doctors, pharmacists, and the pills themselves should not be blamed for the opioid “epidemic”, then who does that leave? The answer is the people who ingest the meds. But we must be careful not to assign blame to all people who take prescription opioids, only to those who abuse them, and that brings us back to the mischaracterization of the problem itself.

According to the Institute of Medicine, 100 million Americans suffer with chronic pain which, if left untreated, costs the U.S. economy $300 billion dollars in lost production each year. By restricting access to prescription opioids, we are, therefore, punishing and prolonging the pain of innocent, law-abiding citizens. Yet those who seem to be criminalizing the use of legitimate medicines, do so by lumping them with illegal drugs.

During his State of the Union address, President Trump told us there were 64,000 opioid deaths in 2016, then said “we must go after the drug dealers,” thus confusing the sale of street heroin with the legal dispensing of pain meds. Also, the figure he cited was the total number of deaths attributed to drug overdoses, but, in truth, the CDC puts that number at closer to 42,000. Nevertheless, only 18,000 of those deaths were due to overdose of prescription opioids, and statistics show that most of those fatalities were the result of mixing other meds and substances with the pain pills. Say what you will, but there is no proof that family physicians are telling their patients to take pain meds while drinking alcohol and popping Valium and Xanax. It’s up to the patient to take prescription drugs as directed, and use some common sense.

I know that one shot of bourbon probably won’t hurt me. But I also know that five shots of bourbon and two beers can do some damage to my body, not to mention cause harm to others if I choose to drink and drive. Speaking of which, according to the CDC, nearly 80,000 people die each year from alcohol-induced deaths, and another 10,000 at the hands of a drunk driver. Yet there’s no outrage by politicians, or a call to make whiskey illegal. And what about the 480,000 people who, between 2005 and 2009, died from tobacco smoking? Shouldn’t the state legislature restrict all adults from buying cigarettes?

There’s no doubt that prescription opioids can be addictive, and that’s why I applaud Wake Forest Baptist Medical Center for leading the way in developing a new protocol for treating pain which is already meeting with great success and satisfaction by patients under their care. But, for now, it serves no purpose for politicians to compare hydrocodone to heroin, misstate statistics, or restrict the proper use of prescription medicines that are designed to relieve pain. Such actions that limit access to meds can actually back-fire, and lead people who suffer with addiction, to turn to heroin instead of seeking help. That’s why we shouldn’t be looking for people to blame, rather, we should focus our efforts on treating those who have abused opioids. Otherwise, we’ll just bring more pain to more people, and that’s the irony and danger of playing the blame game.


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