Medical illiteracy contributes to the opioid crisis | TheHill | by Lynn R. Webster 12/20/16
A recent article in the Washington Post reported, “One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers, according to a new Washington Post-Kaiser Family Foundation survey.”
The article suggests a shocking new finding which supports a narrative that opioids prescribed for pain in America are more dangerous than most people realize.
Most people who use opioids for more than two months become physically dependent on them. But that doesn’t make them addicted to opioids.
Nor does it mean the opioids are harmful to the individual. Herein lies a medical literacy problem.
On the other hand, physical dependence is a normal, generally reversible neuro-adaptive process to a drug. Antihypertensives, antidepressants, and caffeine are other examples of drugs that are associated with a normal physiologic neuro-adaptation process.
Our medical illiteracy allows educated, well-intended people to confuse signs of withdrawal with addiction. This, in turn, leads to potentially misinformed policies
Addiction is commonly used as a pejorative word with a social, cultural, legal, and medical meaning. It is intended to be a diagnostic term, but nearly everyone without training in addiction, including many physicians, seems to have their own definition.
Most readers of the Washington Post-Kaiser Family Foundation survey will believe that it is a scientific assessment of the prevalence of addiction when prescribed an opioid for non cancer pain. It is not. Instead, it is an assessment of attitudes
Unfortunately, most who read about this survey will not realize that.
To them, the article will seem to support the common belief that continued use of painkillers leads to an opioid addiction problem one-third of the time.
This is a mischaracterization of the truth, and it’s a piece of the problem we have with medical literacy.
Lynn R. Webster, MD is Vice President Scientific Affairs for PRA Health Sciences. He is a past President of the American Academy of Pain Medicine. In addition, he is the author of the award winning book, “The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us” (Oxford University Press). Visit him online at www.thepainfultruthbook.com. @LynnRWebsterMD..