Rx Drugs Aren’t to Blame for Rise in Addiction Deaths

Prescription Drugs Aren’t to Blame for Rise in Addiction Deaths – BloombergBy Ramesh Ponnuru – Mar2019

I’m thrilled to see the true fact about the opioid issue prominent in the headline of a mainstream media publication – especially one directed at financial professionals.

“Patients in pain have become collateral damage in the war on opioids.”

Seeing this fact, which is so often voiced by pain patients, simply stated in this article gives me hope that the public will start to realize that opioids are sometimes very needed and not some sort of “evil” substance that “causes addiction”. 

That’s the message of a letter from more than 300 medical professionals, including three former White House drug czars, to the Centers for Disease Control.

Among policymakers, however, the focus is still on cracking down on prescriptions.

Democratic Senator Kirsten Gillibrand of New York and Republican Senator Cory Gardner of Colorado are pushing for a federal limit. Under their legislation, initial prescriptions for acute pain could cover no more than seven days and include no refills.

This is preposterous.

These senators want the federal government to decide that only 7 days of opioid pain relief are “allowed”, no matter what the circumstances, whether a broken arm, 8 broken ribs, crushed pelvis, open heart surgery, various cancers, or any other of the countless ways a human body can be broken and torn apart.

Even the most horrific full-body burns would only be allowed relief for a week, even through the long weeks that their wounds are still being debrided, condemning them to hellish pain for months and years.

There’s no way the federal government can make this decision for every doctor and patient in every situation.

In the senators’ press release, Gardner says: “As I’ve met with Coloradans impacted by the opioid epidemic, the recurring story is clear. Oftentimes, the first over prescription spurs the devastating path of addiction.” [wrong!]

Gillibrand concurs: “One of the root causes of opioid abuse is the over-prescription of these powerful and addictive drugs.” [wrong!]

Later, the article shows how these statements are wrong.

I don’t understand why this silly “mantra” that “opioid prescriptions start addiction” continues holding so many in its grip, so many years after we’ve seen that street drugs, in combination and often mixed with illicit fentanyl, are what people are using when they overdose.

The data also shows that fewer people ever had a legitimate opioid prescription (for themselves) to start their addictive use. Even if prescription opioids were their first drug, they were certainly not prescribed for that person or used “as directed” even if they were.

The bipartisan pair of senators have the same mindset that led then Attorney General Jeff Sessions to recommend last year that people in pain “tough it out” with aspirin rather than opioids

This understanding of the opioid crisis has less and less grounding in reality.

Illicit drugs, rather than prescription medications, have accounted for an increasing proportion of deaths from opioids.

Kudos to Mr. Ponnuru for pointing this out!

The CDC reports 47,600 opioid overdose deaths for 2017.

In some of these cases, illicit substances were also present.

Pain medications, meanwhile, were involved in 14,500: too many, but a minority of all cases

Notice he said “involved in” overdoses, meaning they weren’t the only drug used and they certainly weren’t used as prescribed by the person they were prescribed to.

More and more opioid abusers are starting with heroin. Between 2005 and 2015, the percentage of opioid abusers who started with heroin grew from 9 percent to 33 percent.

Pain patients, contrary to a common view, have a low rate of addiction to opioids when you look closely at the research.

 

A study of nearly 570,000 people who took opioids after surgery received attention when it was published last year for concluding that prescription refills were associated with a “large increase” in rates of misuse.

But the overall rate was low, including less than 1 percent of the sample.

This is the problem when studies report a statistically significant increase in the rate of something: if the base rate was only 1%, but increased to 2%, the 100%  increase that sounds so huge is actually only a minimal 1%.

The study will then claim a 100% increase to alarm, shock, and frighten readers, instead of saying it only increased by 1%.

The campaign against over-prescription of opioids has succeeded in affecting medical practice. The prescription rate peaked in 2012 and has fallen steeply in recent years.

But during this period, the overdose-death rate has kept climbing: Those 47,600 deaths in 2017 set a new record.

It’s to Gardner and Gillibrand’s credit that their bill does not apply to prescriptions for chronic pain.

This is exactly what the CDC opioid guideline also said and we’ve seen the results of such “guidance” when know-nothings use these “suggestions” to create inflexible rules.

But the record of recent years raises the question of whether a federal crackdown is a good idea in the first place.

It misidentifies the root of the problem: It mostly has to do with people who are seeking out opioids for abuse, not who got addicted from prescriptions.

The author is one of the far too few who see the truth of this absurd situation with people overdosing in the streets while patients with severe pain aren’t allowed pain relief.

It is accompanied by a lot of counterproductive political rhetoric that discourages people from getting safe treatment for pain by telling them they will become addicts.

And it does not seem to be succeeding in its fundamental aim of saving lives.

A continued bipartisan focus on prescriptions, though, will guarantee that too much of the war on opioid abuse will keep being fought on the wrong front.

I could not have said it better myself.

3 thoughts on “Rx Drugs Aren’t to Blame for Rise in Addiction Deaths

  1. canarensis

    I just commented on an article on pharmacistSteve’s site about addiction being a brain disfunction, not behavioral (I know you’ve posted on the subject). I was thinking this was a positive step –to start yanking the pervasive “addiction is intrinsic to the substance, not a person” nonsense. I was surprised that the other commenters were angry at it, like it was a diversion from the real issue (we can’t get our pain meds) or just being angry the article was not about pain patients. Then I looked again & saw the paper was from 2011. So much for it changing the thinking (if you can call it that) of the zealots.

    Then we’ve got morons like Gillibrand with the “7 days no refills period” insanity. What may enrage me more than any of this –& this is saying a LOT– is that the people like her who propose these sadistic ideas will never themselves experience denial of pain meds if they really need it. If she were to, say, be in a car crash & get horribly injured & burned, I frigging guarantee that she’d get as much pain meds as she needed, as long as she needed them.

    Liked by 1 person

    Reply
  2. canarensis

    Reblogged this on ecanarensis and commented:
    Zyp has another excellent post…showing more than ever that politics & politicians and facts have not even a passing relationship. This proposal by Gillibrand is unconscionable.

    Like

    Reply

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