Doctors must take the Hippocratic Oath – to do no harm when caring for 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 started in the early 1990s, opioid prescriptions have skyrocketed. The damage they’ve caused has been observed for some time now, including increased opioid overdoses and dependence. ¹

Purdue, a pharmaceutical company and painkiller manufacturer, released an opiate called Oxycontin in 1996. Their marketing was aggressive and stated that “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.”

Due to the expansion of treatments with Oxycontin, the drug exploded in sales. By the year 2000, it was outselling Viagra. However, their deceptive practices came to a head in 2007, when Purdue settled a massive class action lawsuit. It resulted in the company shelling out $637 million for misrepresenting the addictive effects of Oxycontin in their advertising to patients, doctors, and healthcare providers.

A Deadly Numbers Game: Calculating the Demise of the Opiate Epidemic

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are currently an estimated 2.6 million Americans addicted to painkillers. The prescriptions have resulted in an average of 30,000 overdose deaths per year in the United States. ²

Vivek Murthy, the former US Surgeon General, has said: “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.”

Dependency on painkillers has a direct link to heroin use. When prescriptions run out, many turn to the streets for their fix. Not to mention, the cost of heroin is far cheaper. ³

So, what can we do about this epidemic?

Stepping in the Right Direction: Alternatives to Opiates

In terms of healthcare, the first thing that needs to stop is the overprescription of painkillers for those with chronic pain. Chronic pain is a persistent issue and treating it with powerful addictive drugs isn’t going to remedy the situation.

According to the American Chronic Pain Association’s Resource Guide To Chronic Pain Management booklet, the best way to treat chronic pain is to create a balance of exercise, diet, and stress reduction. However, in some severe cases, a doctor can also create an acetaminophen or anti-depressant medication regimen to deal with neuropathic or fibromyalgia pain.

Education is also a necessity for patients and their healthcare providers. These measures can include prevention, detection of addiction, and recovery.

It’s also important to provide funding for drug therapies for those already addicted. Guiding them toward recovery significantly simplifies the complex process and offers an accessible approach to addressing opioid dependency.

Cannabis Fighting the Fight Against Opiate Addiction

Natural alternatives have also been sought after for pain treatment. Perhaps none have received as much attention as cannabis and cannabis-related products.

In a 2018 study, it was found that switching from opiates to cannabis lowered pain levels in patients. On top of this, it curbed opiate cravings, reduced anxiety, and eased stress levels. Not to mention, little to no addiction behavior linked to cannabis use when compared to opiate-dependent users. ⁴

Illinois has gone so far as to create a pilot program within its Department of Health. The goal is to try and get people struggling with opioid addiction to utilize cannabis to help curb their pain levels and dependency.

The Opioid Alternative Pilot Program was seen as a success after launching in 2018 and even expanded its patient base to include veterans who require opiate replacement therapies.

References

¹ Boslett AJ, Denham A, Hill EL. Using contributing causes of death improves prediction of opioid involvement in unclassified drug overdoses in US death records. Addiction. 2020 Jul;115(7):1308-1317. doi: 10.1111/add.14943. Epub 2020 Feb 27. PMID: 32106355; PMCID: PMC9745785.

² Vadivelu N, Kai AM, Kodumudi V, Sramcik J, Kaye AD. The Opioid Crisis: a Comprehensive Overview. Curr Pain Headache Rep. 2018 Feb 23;22(3):16. doi: 10.1007/s11916-018-0670-z. PMID: 29476358.

³ Dash GF, Gizer IR, Slutske WS. Predicting first use of heroin from prescription opioid use subtypes: Insights from the Monitoring the Future longitudinal panel. Drug Alcohol Depend. 2024 Feb 1;255:111084. doi: 10.1016/j.drugalcdep.2024.111084. Epub 2024 Jan 9. PMID: 38232646; PMCID: PMC10842745.

⁴ Griffith C, La France B (2018) The Benefits and Effects of Using Marijuana as a Pain Agent to Treat Opioid Addiction. J Hosp Med Manage Vol.4 No.3:7