Doctors must take an oath, the Hippocratic Oath, to do no harm when it comes to taking care of their patients. This is an oath that is taken seriously and used in the practice of medicine as an ethical barometer when dealing with patients.
However, the “do no harm” clause of the Hippocratic Oath has come into question with the rising rate of prescription opioid addictions and drug overdoses in the last decade.
The question is – now that we know the cost of prescription painkillers and the restriction of prescriptions have no effect overall on the epidemic – what do we do with those addicted?
The Beginning of the Chronic Pain Movement
Since the chronic pain movement that burst on the scene in the early 1990’s, opioid prescriptions have skyrocketed and the damage they’ve caused have been observed for some time now. The rise of prescriptions for opioids can be directly related back to the pharmaceutical companies that create them. Purdue, a pharmaceutical company and painkiller manufacturer, released an opiate called Oxycontin in 1996.
They marketed it so aggressively and directly that they ended up stating that, “only less than one percent of Oxycontin users become addicted and that the drug was safe to use on not only cancer pain but for all sorts of pain, including but not limited to chronic pain, backaches and arthritis.” ¹
Due to the expansion of treatments with Oxycontin, the drug exploded in sales and by the year 2000 was outselling Viagra. However their deceptive practices came to a head in 2007, when Purdue settled a massive class action lawsuit resulting in the company shelling out 637 million dollars for misrepresenting the addictive effects of Oxycontin in their advertising to patients, doctors and health care providers.²
A Deadly Numbers Game: Calculating The Demise of the Opiate Epidemic
According to the Substance Abuse and Mental Health Services Administration, there is currently an estimated 2.6 million Americans addicted to painkillers, such as Vicodin, Percocet and Oxycontin. And the prescriptions have resulted in an average of 30,000 overdose deaths per year in the United States.
Vivek Murthy, the former US Surgeon General, was quoted about the rise of opioid use: “We have nearly 250 million prescriptions for opioids written every year. That’s enough for every adult in America to have a bottle of pills and then some.” ³
Dependency on painkillers have a direct link to heroin use, due to the lack of continuing prescriptions and cost as heroin is far cheaper to obtain. In Huntington, West Virginia there were 28 heroin and prescription drug overdoses in a 5-hour period in 2016, the most that area has seen ever. ⁴
However, we are living in age of opioids and they are necessary in certain cases, so they cannot be abolished. So the question remains, how can we stop the growing rate of addiction, drug overdose deaths with the knowledge that restricting the drug doesn’t really help those addicted?
Well, a solution has been worked on for some time now and while there still isn’t a clear straight answer, there are some steps that the health care system and patients can use in order to combat the opioid addiction epidemic.
Stepping In The Right Direction: Alternatives To Opiates
The first thing that needs to stop on the healthcare side is prescribing painkillers for those with chronic pain. Chronic pain is a persistent issue and treating said pain with powerful addictive drugs isn’t going to remedy the situation.
The best way to treat chronic pain, as presented in the American Chronic Pain Association’s Resource Guide To Chronic Pain Management booklet, is to create a balance of exercise, diet and stress reduction in order to maintain and reduce stress or chronic related pain.
However, in some severe pain-management cases a doctor can also create an acetaminophen or anti-depressant medication regimen in order to deal with neuropathic or fibromyalgia pain.
These methods can be a healthier and safer alternative to treating chronic pain than relying on opioids. Education is also a necessity for patients and their health care providers. Education measures like prevention, detection of addiction, and recovery can not only bring these issues to light but can save lives.
Funding drug therapies for those already addicted and leading them back on the road to recovery dramatically changes the complex process and creates an approachable way to dealing with opioid dependability.
Cannabis Fighting The Fight Against Opiate Addiction
Also there have been some states that have looked into the alternative method of utilizing cannabis and cannabis-related products to try and alleviate pain.
Researchers have been, in an attempt to try and find different ways to treat and manage pain besides opiates, have looked towards cannabis and found some pretty insightful results.
One research study found that not only did a switch from opiates to cannabis lower pain levels but it also curbed opiate cravings as well as reduced anxiety and stress levels.
Researchers have also found that there is little to no addiction behavior linked to cannabis use when compared to opiate dependent users.
Illinois have gone so far as to not only back this research but also made a point to create a pilot program within their department of health to try and get opiate addicted individuals to utilize cannabis and cannabis-related products to try and curb their pain levels as well as their dependency.
The program, Opioid Alternative Pilot Program, was seen as a success after launching in 2018 and even expanded their patient-base to include veterans who are in need of opiate replacement therapies.
The Court System Steps In: Addicts in a Fight for Their Lives
The most recent developments in the fight against the opioid addiction epidemic is a new court system to assist opioid addicts with drug abuse cases and settling suits against pharmaceutical companies.
This project was given a grant of a million dollars from the United States Justice Department in order to develop and execute in one city and analyze the results of having a court system for just painkiller cases.
The first opioid court was opened in Buffalo, New York and its ultimate goal for their $300,000 annual grant was to see “how many people are still breathing each day when we’re finished.” to quote the court project director, Jeffrey Smith.
This opioid court is a unique solution but one that has firm roots in the justice system and goal is to treat addicts and save lives. This is a court system that doesn’t blame the addicts but reasons and stands with them and provide answers and solutions to their struggle instead of prosecuting them as criminals.
The opioid epidemic is a fast spreading, deadly situation but it’s not unbeatable. And although restricting the drug to those who actually need it with proper dosing is a great start, we still have work to do. Measures like education to everyone, creating an approachable path for therapies for those who are addicted offer assistance to those addicted.
As well as the new concept of opioid courts that don’t condemn addicts like criminals but offers addiction treatments in order save lives is a tremendous step forward. Coming together with the help of patients, the healthcare community and the court systems, we can end the epidemic and bring back a balance to healing pain in a healthier and safer manner.
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¹ NYTimes: “Opioid Prescriptions Fall After 2010 Peak, C.D.C. Report Finds.”
² NYTimes: “The Numbers Behind America’s Heroin Epidemic”
³ CNN: “A Historic 1St: The Surgeon General Reaches Out To All Drs For Help With A Vicious Epidemic”
⁴ CNN: “W. Virginia City Has 27 Heroin Overdoses In 4 Hours“