Understanding the Opioid Epidemic

October 4th, 2018

By Dr. Joseph Mercola

Contributing writer for Wake Up World

With an estimated 11 million Americans abusing prescription opioid medications, opioid overdose is now the leading cause of death for Americans under the age of 50. So, how did we get here?

According to the U.S. Centers for Disease Control and Prevention (CDC), 115 Americans, on average, die of an opioid overdose every day.¹ The increasing use of opioid painkillers and the rampant rates of addiction to them have become a social issue that transcends all geographic and socioeconomic boundaries. Drug overdoses now affect people of every age, gender and ethnicity.

“Understanding the Opioid Epidemic” is a one-hour PBS documentary designed to highlight some of the issues surrounding the disturbing rates of use and abuse of prescription opioid medications in the U.S. If you or someone you love is taking opioids or is already addicted, you may find solace and validation by hearing from recovering addicts and their family members. Also featured are patient advocates, doctors and other experts who deal with this issue on a daily basis. You can watch the entire documentary below.

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Painkillers Prescribed for Common Medical Conditions Can Be a Gateway to Opioid Addiction

Far from being an epidemic of nameless, faceless people from faraway lands, the U.S. opioid crisis makes front-page news week after week. The headlines include heartbreaking stories from people like Avi and Julie Israel of North Buffalo, New York, whose son Michael’s story is featured prominently in the documentary. Michael was diagnosed with Crohn’s disease at the age of 12. Problems with drug addiction began when Michael transitioned from his pediatrician to a gastroenterologist when he was 18.

To address Michael’s pain, the new doctor prescribed hydrocodone (sold under the brand names Norco and Vicodin), a semisynthetic opioid derived from codeine. That one choice changed Michael forever.

After obtaining a court order to review Michael’s pharmacy records after his death, the Israels discovered their son had been prescribed 185 pain pills in little more than a 30-day period just a few months before he died.² “I couldn’t believe the doctors did this to him,” declared Julie. “It’s indefensible. … It changed him chemically forever.”

Sadly, after his addiction to prescription opioids and other medications overtook his life, Michael committed suicide in June 2011. He was 20. In the film, Avi and Julie expressed their sadness over the reality that many who become addicted to opioids are treated like outcasts, especially by people whose lives have not been directly impacted by this crisis.

Said Julie, “The people who are not affected do not think it will happen to them, but that’s a naïve perspective. You are one car accident, one surgery, one wisdom tooth or one sports injury away from addiction. That’s how fast it can happen to your family.”

While you may not think opioid addiction can happen to you, these potent painkillers are routinely prescribed for the treatment of bodily pain related to accidents, car crashes, sports injuries and surgeries — experiences that are common to people everywhere.

Sports Injuries Are Another Launching Point for Opioid Addiction

As mentioned, opioid addiction can easily begin with an injury or surgery. While you may not realize it, taking prescription opioids puts you just a few steps away from becoming a heroin addict or falling victim to synthetic opioids such as fentanyl. Dr. Andrew Kolodny, director, opioid policy research at Brandeis University, says:

The effects of these drugs are indistinguishable from the effects produced by heroin. When we talk about opioid prescription drugs, we are essentially talking about ‘heroin pills’.

Jennifer Weiss-Burke, executive director of Serenity Mesa Youth Recovery Center in Albuquerque and mother of student-athlete Cameron Weiss, who died of a heroin overdose in August 2011, knows that full well. Around age 16, Weiss had the misfortune of breaking his collarbone — twice — the first time while wrestling, which required surgery, and several months later while playing football.

On both occasions, Weiss was prescribed opioids to help him cope with the intense pain. Unfortunately, the prescribed medications served as gateway drugs for him, and he later moved on to heroin, which is regarded as a cheaper substitute for prescription opioids. About the effects of drugs on his life, Weiss-Burke writes:³

“Cameron became dependent and then addicted to opioids. He quickly progressed to a heroin addiction when he no longer had easy access to pills. Heroin was cheaper and easier to get. He smoked heroin for about a year before he began injecting the drug. He had always said he would never put a needle in his arm, but the drug beckoned, and he listened.

Drugs changed Cameron almost overnight. He went from being a compassionate young man who loved spending time with his family, to a young man who made heroin his primary focus. School, sports and family — everything took a backseat to his addiction. The drug became his world and it controlled him like a puppet on a string.

He was no longer using to get high, he was using to feel ‘well’ and to not be sick. Becoming addicted to drugs and dying as a result of his addiction was the last thing Cameron (or our family) ever thought would happen to him. Cameron would want everyone to know that if it can happen to him, it can happen to anyone. No one is exempt from this terrible disease.”

What Are Opioids and How Are They Used?

If you’ve ever received a prescription for painkillers, you’ve likely taken an opioid. These powerful pharmaceutical medications are commonly used to treat moderate-to-severe pain despite the many serious risks and lack of evidence about their long-term effectiveness. They are often prescribed after an injury or surgery, or to relieve pain associated with chronic health conditions such as cancer, fibromyalgia and inflammatory bowel disease, among others.

A few of the most popularly prescribed drugs are oxycodone (sold under the brand name OxyContin), hydrocodone, morphine and methadone. Regardless of whether you have a history of legal or illegal drug use, anyone who takes prescription opioids for any length of time runs the risk of becoming addicted to them.

Once addicted, it can be hard to stop using these medications. “Patients and prescribers really need to understand that opioids are highly addictive,” states Dr. Richard Blondell, vice chair for addiction medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo and first director of the National Center for Physicians Training in Addiction Medicine.

“It doesn’t mean they should never prescribe them or that a patient should never take them. It means we have to be very careful with these drugs.” On the other hand, when used properly, opioids can provide much-needed pain relief to get you through the early hours and days of an intense healing and recovery process.

Whenever the subject of pain medication is brought up, it’s important for you to ask questions about your pain-management options and also the potential risks of opioid addiction. Both you and your doctor should carefully consider risk factors such as your family history, genetics, history of substance abuse or addictions, mental health, psychological or social stressors, and history of trauma. These factors may increase your risk of addiction.

Facts About the Opioid Epidemic

David Thomas, Ph.D., health scientist administrator with the National Institute on Drug Abuse (NIDA), was a pain and opioid researcher for 12 years before joining the NIDA. Regarding the opioid epidemic, Thomas said, “The rate of death from prescription opiates has been exponentially growing. And that’s only the tip of the iceberg in terms of how many lives are wrecked because of prescription opiates. It’s a huge problem.” About the opioid epidemic that has taken the U.S. by storm since the mid-1990s, the CDC says:^4,5

• More than 11 million Americans abused prescription opioid medications during 2016.
• From 1999 to 2016, more than 630,000 people died as a result of a drug overdose.
• About two-thirds of the more than 64,000 drug overdose deaths in 2016 involved an opioid.
• The number of overdose deaths involving opioids was five times higher in 2016 than it was in 1999.
• Drug overdoses have become the leading cause of death among Americans under age 50. ⁶

About the issues related to opioids, Kolodny asserts, “The reason the U.S. is in the midst of a severe epidemic of opioid addiction is because the medical community began to prescribe opioids very aggressively. And as the prescriptions went up, rates of addiction and overdose deaths went up right along with the increase in prescribing.”

Prior to the release of the documentary, Kolodny told The New York Times, “We have roughly two groups of Americans that are getting addicted … an older group that is overdosing on pain medicine, and … a younger group that is overdosing on black market opioids.”⁷

The Opioid Crisis Is Damaging Society and Costing Us Millions

While the issue is multifaceted, Kolodny suggests drug makers and physicians play a big role in the opioid crisis. After all, without pharmaceutical companies, the painkilling medications in question would not exist, and doctors are the ones responsible for putting prescriptions into the hands of their patients.

“The only way you can do well financially and have a blockbuster drug is to get the medical community to prescribe your medication for common conditions and long-term conditions,” says Kolodny. “And if it’s a drug that is very difficult for people to discontinue using, then you’ve got a pretty good recipe for a blockbuster.”

Over the years, several states have filed lawsuits against drug manufacturers related to misleading marketing campaigns and failure to disclose addiction risks for drugs such as OxyContin. The U.S. Department of Health and Human Services estimates the economic cost of opioid abuse to average about $75 billion annually — with $55 billion attributed to health and social costs and $20 billion to emergency department and inpatient treatment associated with opioid poisonings.

The majority of these costs are borne by Medicare, Medicaid, the Veteran’s Administration and private insurance companies. In most cases, these organizations pay twice — once for the opioid medications themselves and a second time when the patient seeks treatment for an addiction or overdose. Notably, alternative pain-relieving treatments such as acupuncture, chiropractic, massage, physical therapy and others are not well understood and are even less often covered by insurance.

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Better Solutions Exist Beyond the Prescription Pad

For some doctors, writing a prescription is simply a faster way to address a patient’s concern. For some patients, taking a pill or two a day seems more convenient than scheduling alternative therapy appointments or participating in weeks of physical rehab. Regardless, painkillers are not a long-term solution. Dr. Daniel Alfred, director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program at Boston University School of Medicine, claims he has a solution to make the opioid crisis go away. He states:

“… If the insurance industry would pay for comprehensive pain-management services under one roof where you can get massage therapy, cognitive behavioral therapy, acupuncture, medication management and — you name it — things would change.

I want patients to start demanding multimodal, comprehensive pain-management treatment. I want them to say to their doctors, ‘I need something better.’ They should be calling their insurance companies asking, ‘Why do I not have access to these therapies?'”

Kolodny suggests the best approach to dealing with the opioid crisis is prevention. Similar to Alfred, as a secondary measure, Kolodny notes we need new and better treatment approaches to support those who have become addicted, especially with respect to preventing overdoses. In addition, and most assuredly, education is an important factor to stem the tide of opioid addiction. Students, parents, doctors, educators, policy makers, public health officials and others need to better understand the risks associated with taking (and prescribing) opioid medications. Education was one of the premises for making the documentary, featured below.

Concludes Dr. Blondell:

“It doesn’t have to be like this. Our society doesn’t have to be riddled with addiction. We don’t have to read about all these people who overdosed. We can do better. We know what to do. It’s just getting the will to do it that is the hard part.”

What Can You Do to Avoid Painkillers and Overcome Opioid Addiction?

If you’re struggling with opioid addiction, please seek professional help immediately. At the same time, a major step toward health when dealing with chronic disease of any kind, including opioid addiction, is to make dramatic changes to your diet and lifestyle. Below are four areas to address as a primary strategy:

• Eliminate or radically reduce your consumption of grains and sugars.
• Increase your intake of animal-based omega-3 fats.
• Optimize your production of vitamin D.
• Radically reduce your intake of processed foods.

Beyond that, if you suffer from chronic pain of any kind, you need to know there are many natural, safe and effective alternatives to over-the-counter and prescription painkillers, including the following:

Astaxanthin: As an oil-soluble antioxidant, astaxanthin has very potent anti-inflammatory properties; you may need 8 milligrams or more per day for pain relief.

Boswellia: Also known as “Indian frankincense,” this herb contains powerful anti-inflammatory properties, which worked well for many of my former rheumatoid arthritis patients.

Bromelain: This protein-digesting enzyme, found mainly in the core of pineapples, is a natural anti-inflammatory; it can be obtained from the fruit or taken in supplement form.

Cayenne cream: This spice comes from dried hot peppers and alleviates pain by depleting your body’s supply of substance P, a chemical component of nerve cells known to transmit pain signals to your brain.

Cetyl myristoleate (CMO): This oil, found in dairy butter and fish, acts as a joint lubricant and anti-inflammatory; it has been useful to relieve ganglion cysts and mild cases of carpal tunnel syndrome.

Curcumin: A therapeutic compound found in the spice turmeric, curcumin has been shown in more than 50 clinical studies to have potent anti-inflammatory activity; it is best taken in capsules and you can take two to three every hour as needed.

Evening primrose, black currant and borage oils: These oils contain the fatty acid gamma-linolenic acid, which is useful for treating arthritic pain.

Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties.

Kratom: Mitragyna speciose, also known as kratom, is a plant remedy and psychoactive substance that has become a popular opioid substitute,8 but only when used carefully; it can also be addictive so use it only under the guidance of qualified medical personnel.

Low-dose naltrexone (LDN): An opiate antagonist originally developed in the early 1960s to treat opioid addiction, today’s prescription LDN triggers endorphin production, which can boost your immune function and ease pain

I highly recommend “Understanding the Opioid Epidemic.” It’s well worth your time to watch this engaging and informative documentary about one of the biggest social issues of our time. Now more than ever, you must become educated about opioids and the harmful effect they are having on the U.S. and Americans of all ages and from all walks of life.