The Dark Side of Opioids for Pain Relief

In her recent broadcast, Why Opioid-Related Deaths Continue to Rise and What Can Be Done to Reverse the Trend, popular National Public Radio host and author Diane Rehm touched on the central problem of doctor-prescribed opioid pain killers: they are highly addictive and too easy to dispense. Under the culture of quick fixes, doctors readily hand out prescriptions when a milder, less abusive option is available. Why is this?

The fact is these medications are not safe. Nearly twenty percent of Americans already take at least five or more prescription drugs regularly. And rarely, if ever, are these prescriptions cross-checked. In a startling statistic on causes of death in the U.S., total drug overdoses from prescribed medications alone, including opiates, killed more Americans than firearms or motor vehicle accidents. The real crux of our nation’s heroin epidemic stems from the overprescribing of opiates, legally. Nearly four out of five current heroin addicts state that they began using illegal drugs only after being prescribed opiates by doctors for pain.

So what is the reason why so many Americans are on prescription drugs?
The risk of addiction is high, whether for school athletes, parents of young children or seniors. Isit that doctors are simply too heavy-handed with their prescription pads? Are these doctors being influenced by Big Pharma and believe that prescription drugs are a quick fix to all our health problems? The honest answer is that, yes, physicians have been giving out way too many prescriptions, and in their defense, patients also do not want to leave the office without a script. In her new book, Drug Dealer, MD – How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop, author and psychiatrist Anna Lembke, MD, points out that we live in a society today that does not want to feel pain.

Per Dr. Lembke, this change in thinking about pain marked a radical shift in America’s attitude from 100 years ago, when the medical community thought that pain made patients stronger. “Doctors believed that pain was salutary,” she tells Fresh Air’s Terry Gross, “meaning that it had some physiologic benefit to the individual, and certainly some spiritual benefit.” Today, not only do doctors believe that pain is something they must cure at all costs, but patients have become less willing to endure it. Further complicating the whole transaction is that for too long there has never been any oversight.

Are there alternatives to effectively manage pain?
Now, with prescription drug monitoring programs, the easy prescribing habits of doctors have come to a halt. Still, pain is real and very often patients are the ones having to manage it. Can I restore quality of life without having major surgery or popping too many pills, they ask? Yes, a better way to approach pain relief is to target the different ways in which pain is produced. It’s not about adding more and more, but about treatments complementing and enhancing one another to reduce inflammation, alleviate anxiety, decompress nerves, increase metabolism, lower toxicity, reduce unnecessary pills, and so on. Studies have shown that statin drugs, for instance, are a primary predictor of pain. Likewise, an eleven to eighteen percent reduction in body weight significantly decreases the severity of pain. By taking a holistic, functional approach to pain relief, patients find there are numerous ways to restore quality of life that can be sustained into old age.

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