Opioid Drugs - A Modern Day Health Crises Part 1

Opioids really have become a modern day health care crisis!

We have an opioid epidemic in the US due to the use and abuse of these drugs that has become a nightmare public healthcare issue. So the purpose of this blog is help prevent you from becoming a statistic!

We know beyond doubt that pain is created in the brain. When you feel pain, it’s because your brain has decided you need to feel pain either due to tissue damage or potential tissue damage.

Pain exists to warn us that we are creating an issue, or that damage has already occurred. Or it can let us know what we shouldn’t do so we can heal. So, it’s not a good idea to mask this pain, but instead we need to work with our body so that we know if we are healing or not. As you can see, pain can actually be very useful!

Opioids are designed to trick your brain into not feeling pain, and while on the surface this sounds great, it’s not always such a great idea at all! There’s actually a ton of issues associated with trying to trick the brain, just a few of which are mentioned above.

A lot of people don’t realize that these opioid drugs are very similar to heroin, which was originally commercially produced as an alternative to morphine around the turn of the 20th century. The theory at the time was that it was less addictive than morphine. But look at the issues with that drug now!

So then 20-30 years ago we started mass producing and marketing oxycontin (the most commonly used opioid drug). What’s maybe most frightening is that initial marketing tactics aimed around pushing this drug to doctors who the drug companies flagged as opiate over-prescribers. Much like heroin it was falsely marketed as safer and less addictive than heroin, but these companies were hiding the truth. It actually functions just like a slow release heroin, and is highly addictive plus it has horrific withdrawal symptoms. People feel so miserable trying to come off it that they end up just using more and more, hence why overdoses due to opioid usage are going through the roof!

Deaths associated with prescribed opioids have quadrupled since 1999 in line with the sales of these drugs. There were 250 million prescriptions in 2013 filled, 4 times more than in 1999. All this with no increase in the amount of pain people report.

That’s almost enough prescriptions for every person in America to have their own bottle. They guess 183,000 people died in the US due to overdosing between 1999 to 2015 on legally prescribed drugs. Added with heroin, 91 people a day die in the US due to opioid overdose and is rising rapidly.

26-36 million people worldwide abuse opioids every year. Something has to stop this madness! It’s ironic that a drug designed to reduce suffering has perhaps created more suffering than anything else ever created!

The cost to the US economy of opioid overuse and abuse is $78 billion!! That’s more than the GDP of two-thirds of the countries around the world. What’s worse, some companies are doing everything they can to maximize profits even knowing the damage caused. Executives are being jailed for bribing doctors, yet the train just keeps on running.

There are zero studies that have evaluated long term effects (greater than 3 months) of opioid therapy vs non opioid therapy for pain, disability, health and so on. Many observational short-term studies suggest that opioid therapy for chronic pain is associated with increased risk for overdose, opioid abuse, fractures, myocardial infarction, and markers of sexual dysfunction. Sounds great, right?!!

So there is zero evidence to say they work in the long term, and there is quite a bit of evidence to say that they cause harm. And even if they did work, we don’t even know how much we should be giving. Isn’t that crazy?!! And yet we demand that Chiropractic and anything else non-medical is “evidence based.”

How many millions of people are prescribed these drugs and we don’t even know if they’ll work?

Because pain is being shown to be very important for the tissue and wound healing of our body, and the opioid pathway is an important factor in this process, it’s quite dangerous to interfere with it. And that’s exactly what opioid use does, it interferes with immune function and wound healing, which is why you see opioid addicts who look like they’re a walking infection.

The other pain drug options aren’t much better. There’s evidence that NSAIDs (non-steroidal anti-inflammatory’s) also affect wound healing, especially when bone damage occurs. One literature review suggests that the long-term use of NSAIDs for managing fracture pain and inflammation carries the risk of impaired bone healing, and they have the potential to create severe adverse effects of multiple body systems (Gastro-intestinal, cardiovascular, and renal systems) leading to significant increase in illness. Careful consideration should be given to these effects before prescribing NSAIDs for bone or tissue damage.

So what does the CDC make of all of this regarding opioids and their lack of evidence? Their recommendations as treatment for chronic pain are as follows:

• No evidence exists of a long-term benefit of opioids versus no opioids for chronic pain, with most placebo-controlled randomized trials only being less than 6 weeks in duration.
• Extensive evidence shows the possible harms of opioids.
• Extensive evidence suggests some benefits and far less harm of nonpharmacologic-treatments compared with long-term opioid therapy.

The CDC is clearly saying don’t take drugs for chronic pain, and if opioids are really needed then 3 days or less is all they should be used for, and absolutely no longer than 7 days.

But despite this, an estimated 20% of pain patients that report to a medical facility in this country will get a prescription for opioids, and thus starts their drug addiction.

Next week we will discuss what can be done instead of going down the medication road when it comes to pain management.