Patients shut out of the debate over opioid pain medicine

Why are patients shut out of the debate over prescription pain medicine? – The Washington Post

While millions of Americans suffer severe chronic pain, their voices are rarely heard in media coverage of the “opioid epidemic.” Many stories fail to quote them at all.

And when advocates for patients are heard from, the spokesperson is typically someone described as a recipient of pharmaceutical industry funding, and thereby discredited. [See Patient Advocacy motives and integrity questioned by PROP]

But look at the comments to these stories, and you’ll get a different picture.

Other journalists who take the time to ask pain patients for their perspective can get overwhelmed with dozens of heartbreaking stories of suffering.

The media also give a false impression of the role of pain treatment in causing opioid addiction.  While most coverage includes anecdotes about people who became addicted during medical opioid use, the research shows that most opioid addicts actually start as street users and were never pain patients at all.

National Household Survey on Drug Use and Health has asked thousands of Americans about their misuse of prescription drugs, and the sources from which they get their supply.  And consistently, the answer is that at least 80 percent are not pain patients who were medically addicted.

two-thirds of the heaviest prescription drug users are not seeing doctors to get their drugs at all.

A review of the literature by the highly respected Cochrane Collaboration found that less than 1 percent of patients without a prior history of addiction become addicted during long-term opioid treatment for chronic pain. The review collected data from nearly 5,000 patients.

ABC News stated as fact that “Powerful painkillers like vicodin or percocet relieve pain but aren’t intended to treat patients long-term.” Some doctors certainly take that perspective — but if it were the consensus in medicine, there wouldn’t be enough data for a Cochrane Review on the issue, let alone one that tentatively concludes that such treatment can be effective.

the data suggest that most of these opioids are not being prescribed for chronic pain patients. Otherwise, doctors themselves would be directly supplying a far larger proportion of the opioids used by addicts.

Policymakers and anti-addiction advocates now want to suppress opioid use, and to impose even greater restrictions on people who live with chronic pain. This isn’t going to address the addiction and overdose problem. Studies are now showing that when opioids aren’t as available and prices go up, addicts just switch back to street heroin.

Pain patients, however, simply suffer. Their plight shouldn’t be an afterthought and shouldn’t be relegated to comments sections to stories that failed to consider their perspective. They are a crucial part of this story.

(Guest post from journalist Maia Szalavitz, author of the forthcoming book “Unbroken Brain:  A New Way of Understanding Addiction and Other Compulsive Disorders.”)

Maia is one of the few journalists with both addiction experience and an understanding of why pain patients need opioids.  As far as I know, she doesn’t suffer chronic pain herself, yet she has been tirelessly promoting our cause.

1 thought on “Patients shut out of the debate over opioid pain medicine

  1. Pingback: Patients shut out of the debate over opioid pain medicine | All Things Chronic

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