Opioid Crisis

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number of opioids needed to be effective to stop pain and the amount that might kill a person is small and unpredictable. Cannon showed on a big screen the chemical makeup of oxycodone and then heroin and the two were nearly identical. What oxycodone, prescribed widely by doctors, does to a person’s body is the same as what the illegal and often deadly heroin does.

Cannon told the crowd that opioids have never been proven to be effective and using ibuprofen to treat pain or alternative therapies, such as acupuncture, homeopathy, or behavioral therapy are both safer and give results. “To this date, there is no well-designed research that opioids are effective for chronic, non-cancer pain, or that they’re more beneficial than harmful,” the doctor stated.

And yet, when he asked audience members to raise their hands if they’ve ever been prescribed opioids after surgery or for pain, almost everyone raised their hands. One man asked why, then, if opioids haven’t proven to be effective have they been so widely prescribed.

Cannon replied that they were pushed in the early 90’s by the pharmaceutical industry, who first created a narrative that physicians were undertreating pain. The drug maker Purdue Pharma first launched OxyContin in 1996 and spent billions promoting its products to doctors. The company funded groups that sold themselves as patient advocates but who were really lobbyists for the drug manufacturers. The government was then controlled by the powerful drug companies and doctors, who were once flagged for overprescribing, were instead encouraged to prescribe these types of drugs.

The number of prescriptions for opioids went from 70 million in the ’90’s to well over 200 million today. The United States is the only country that pushes opioids for pain medication, Cannon related, and, in turn, is the only country with so many opioid-related addiction cases and deaths. Other nations use homeopathy or therapy to treat pain, things the American insurance companies rarely cover.

An audience member asked if there’s any movement to get the insurance companies to pay for alternative therapies and Cannon told her there was not. “The insurance companies and the pharmaceutical industry have a very powerful lobbying group,” he said. “The people that have the money and the power are stopping that change from happening.”

Prescription opioid use and illegal heroin use go hand in hand. Four out of five heroin users started by taking opioid prescribed by their doctors. The common use of fentanyl, a deadly substance mixed in both heroin and in counterfeit opioid pills, has increased the number of deaths in the U. S. drastically. Fentanyl is a chemical that comes primarily from China and can be purchased on the internet. Drug dealers mix it with heroin and pills because it is significantly cheaper than using real opioids.

“There’s millions of these out there on the street getting sold and people think they’re buying OxyContin and they’re really buying fentanyl,” Cannon said. He added that, for every one death from opioids: 10 people are admitted for addiction; 32 visit the emergency room; 130 people are abusing; and 825 are using the drug non-medically.

McNeill spoke next, relating that he had ankle surgery a few years ago and his surgeon prescribed opioids for his pain. McNeill did not use the opioids and rather took an over-the-counter pain reliever that proved to be adequate.

Gulvas asked if a person’s body needs pain medication to heal properly after surgery. The body will heal regardless of being in pain or not, Cannon replied. “And you can fight pain with things other than opioids,” he stressed. “This notion that you have to have opioids to treat pain is not true.” Gulvas added that she’d always been a person who trusted whatever her physician said and, through this lecture, has learned to question what she is prescribed.

McNeill went on of how he and other doctors are now taking steps to try to reverse the opioid crisis. These steps include prescribing opioids less and making alternative pain management available. There’s also a movement to screen patients better, identifying those who are more likely to become dependent on drugs and doing annual drug tests to make sure the patient is taking his prescriptions properly.

Patients who are now prescribed opioids, McNeill continued, are warned about the effects of the drug, required to have frequent face-to-face visits with their doctors, and are limited in the number of pills given; usually no more than a week’s worth are prescribed. Providing further assistance to doctors is the state’s PDMP, Prescription Drug Monitoring Program, which is an electronic database that lists all prescriptions given to a patient from all providers, be it physician, dentist, or pharmacist.

“We’ve been educating doctors about the risks of opioids and how to treat individuals for abuse,” McNeill said, noting it’s a departure from his medical school days when he was encouraged to write prescriptions for opioids. He reiterated that patients have to be informed and question what they are prescribed. “You’re in control. You have to advocate for yourself and we, as doctors, have to do better on our end,” he said.