Pain Medication is Not a Gateway to Heroin | The Fix | Zachary Siegel | 04/10/16
This article is written by an expert on opioids: he was an opioid abuser (and with this article, also proves that it’s entirely possible to stop)
To say, as the CDC did, that both pain patients and doctors are the culprits in rising mortality is misguided for several reasons.
As the death toll from opioids and heroin rises, people are looking for answers, and also, someone to blame.
The director of the Centers for Disease Control and Prevention, Dr. Tom Frieden, thinks he’s found both, in light of recently calling the epidemic of overdoses “doctor-driven,” where it’s urged that prescribers rein in the number of patients—particularly those with chronic pain—prescribed to opioid pain relievers.
He believes that the epidemic “can be reversed in part by doctors’ actions.”
The less prescription painkillers out there, in theory, the less chances there are of people becoming addicted to them
This is the tired old refrain of the drug-war, spending billions of our tax dollars trying to limit the supply of various undesirable drugs. It has been repeatedly proven ineffective, but the DEA marches on, sometimes in direct conflict with scientific facts.
But there is a catch: the 8 million chronic pain patients currently prescribed to opioid pain relievers, the overwhelming majority of whom are not addicted, will see their supply cut off.
So why should this group be bearing the brunt of restrictive policies and regulations when they’re not the ones contributing to the extreme death toll in the first place?
The panic over pain pills has reached far and wide.
One New Jersey hospital, which appears to have taken the CDC guidelines to their extreme, became the first in the country to abandon the use of opioid pain relievers all together.
If you had a broken wrist would you want to be rushed to this ER?
Why would anyone with a serious injury ever choose non-opioid pain treatment?
Should this become the norm in an era when opioids are available, effective, and have fewer side-effects than any of the alternatives? Can we even call it pain treatment if it only reduces pain by less than 10%?
The only 2 serious side effects of opioids taken correctly for pain are
- a 3%-5% potential for addiction, which is treatable, while chronic pain is not.
To say, as the CDC did, that both pain patients and doctors are the culprits in rising mortality is misguided for a few reasons:
1) patients who suffer from chronic pain rarely misuse their medications or wind up addicted;
2) over 75 percent of people who misuse prescription painkillers score them the old fashioned way—from friends and dealers or other illicit sources, rarely physicians; and finally
3) the CDC itself found “those at highest risk of overdose are about four times more likely than the average user to buy the drugs from a dealer or other stranger,” not through a doctor’s prescription.
So the hard truth behind opioid prescribing, which the CDC neglects in its guidelines, is that the vast majority of people on them simply do not develop a dependency.
Here, even one of our supporters uses the wrong word. We become dependent on opioids like we do on many other medications taken regularly. Antidepressants are the most extreme example of horrible withdrawals resulting from non-DEA-targeted, common prescription pills.
We become dependent on opioids like we do on many other medications taken regularly, but addiction is a separate condition. Antidepressants are an extreme example of horrible withdrawals resulting from non-DEA-targeted, common prescription pills.
“gateway to heroin.” The story goes, unsuspecting pain patients are being prescribed opioids, which turns them into mindless, opiate-eating zombies, and once the prescription runs dry, they turn to heroin. People attribute this false trajectory as another primary cause of the current opiate crisis.
Stories such as mine [Zachary] are helping fuel the panic, that the leap from (legitimate) prescription painkillers to heroin—for people without substance use histories—is a common occurrence and contributing to swaths of opioid and heroin poisonings. And as a result, people who actually need opioids are being undertreated because of the new heroin hysteria
People are not moving toward heroin in the way it’s being portrayed. A 2013 study by SAMHSA found that even among the non-medical use of prescription pain relievers—i.e., people who took them without a prescription—the “vast majority” did not progress to heroin use. Only 3.6 percent of this group began using heroin within five years after their first non-medical use.
Misusing other drugs, especially while you’re young, is a good predictor of future problems with addiction. In fact, most people who develop an addiction to opioids likely already have experience taking illegal drugs.
It’s worth pointing out that after my first legitimate prescription (from the ankle injury), I was not hooked.
But my use, and the majority of people who use illicit opiates—the ones who are likely to die from an overdose—was not “doctor-driven.”
The supply of OxyContin also wasn’t coming from a doctor. It was diverted through means I never fully understood.
Restricting the supply of opioids for people who need them will not make a dent in rising mortality. It’s simply the wrong target.
Instead of cutting the supply of painkillers—which, as history tells us, only drives more people to black markets—why not put more resources into adequate, science-based treatment, so those who do get addicted get the help they need?
Cutting the supply without a safety net to catch them sounds like another disaster waiting to happen.
Lastly, no one really understands why people, especially young people today—among whom heroin use has more than doubled in the past decade—are dulling themselves with a powerful, dangerous drug.
Yes, this is the real issue, obscured by all the hysteria:
Why are so many people so desperate to escape reality reality that they are willing to risk the many, and sometimes deadly, consequences of this escape?
It’s this pain that must be understood and alleviated.