Do Opioids Serve ANY Purpose?
The overprescription of powerful opioid painkillers has led to hundreds of thousands of unnecessary deaths and millions of unsuspecting addicts. No one can argue that point. It’s as cut and dry as saying the sky is blue or grass is green.
There is, however, a debate currently raging across the country about whether opioids are medically necessary, whether they offer any real benefits to pain-suffers. That answer isn’t so cut and dry.
Stanford University recently played host to two experts on the subject – Sean Mackey, a pain medicine expert, and Anna Lembke, an addiction expert. The two squared off in a public debate over the state of pain medicine and abuse in America.
This debate, at its most basic, comes down to whether you empathize with the millions living with pain or the millions living with addiction. It’s not easy to pick sides.
No matter where someone’s allegiance falls, there’s one thing we can all agree on. Doctors, pharmacies, and medical specialists of all stripes need better training on how to treat chronic pain and addiction.
Both Mackey and Lembke pointed out that most medical students receive only seven hours of pain medicine training and no hours of addiction treatment training. Something needs to change and it needs to happen now.
Chronic Pain is Real & Debilitating
According to the most recent statistics, around 100 million Americans suffer from chronic pain. While that number is large (breaking down to almost a third of the population), it’s not a huge stretch.
Remember, chronic pain includes everyone from those with persistent back issues, like myself, to those who’re unable to get out of bed due to pain.
Mackey, in his defense of opioid painkillers, noted they work remarkably well for controlling short-term pain. There’s a reason morphine has been the gold standard of pain control for centuries. He also noted that there are some cases where using painkillers to treat long-term pain makes sense.
Another point Mackey brought up was how society has stigmatized taking painkillers for medically necessary reasons. Doctors are hesitant to prescribe them, patients are unwilling to take them, and the DEA is quick to crack down on them.
Finally, it’s worth pointing out that although opioids cause the majority of prescription drug deaths, they’re not alone. In fact, of all the drug overdose deaths in 2011, 31% were attributed to benzo’s alone. That still leaves a large percentage of painkiller induced deaths, but less than is commonly thought.
The Deadly Side Effects of Painkillers
There wouldn’t be a debate around opioids if both sides weren’t taken into consideration. So, what’re the cons of prescription painkillers? Well, there are more than a few.
Over 200 million prescriptions are written each year for opioids. This had led to a drastic increase in overdose deaths. They numbered at around 4,000 in 1999. By 2013, that number had more than tripled to approximately 16,000.
There’s the obvious risk for addiction. A bit more subtlety, though, is the risk for cross addiction. As the government has tightened restrictions on painkillers in recent years, there’s been a surge in heroin addiction and overdose.
This is the classic example of moving from one addiction to another. Users may start out with painkillers and move onto heroin as painkillers become harder to get their hands on.
There are also a number of other medical risks associated with opioid addiction. These are things like constipation, an increased risk for heart attack and bone fractures, and lowered testosterone.
Alternative Ways to Treat Pain
Regardless of whether you think painkillers are medically necessary or not, there’s one more question that needs to be answered. That question, simple as it may be, is what opioid alternatives are out there?
Well, Mackey runs a pain clinic and, in his experience, there are plenty of other options. When asked this question, he responded by saying,
“We all come together in a team-based environment, with pain medicine physicians across all walks of training — anesthesiologists, PM&R neurology, psychology, internal medicine…We’ve built it with pain psychology, with physical therapy, with dietary, with biofeedback. And we do it in a co-located, coordinated model” (Vox).
If that seems too daunting, after all not everyone has access to pain experts, there are still other options. These include things like yoga, meditation, eastern medicine, and even “detox” meds like Suboxone to help painkiller patients detox. There’s also the somewhat controversial choice of medical marijuana.
Regardless of how someone chooses to deal with their pain, or where your personal beliefs lie in regards to opioid painkillers, one fact shines through. As mentioned above, America needs a change and we need that change now. Too many people are dying to continue down our current path.
It’s debates like the one that took place at Stanford, debates between informed and caring citizens, which will lead to meaningful change. Of that I’m sure.
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