I-TEAM: Opioid addiction versus dependency – By: George Knapp – Feb 22, 2018
Millions of chronic pain patients, already living in agony because of disease or injuries, now live in fear that their medicine will be taken away because they’ve been stigmatized as drug addicts.
Ninety percent of those who die of overdoses use illicit drugs.
Why is this still invisible to policy-makers? I don’t understand how any reasonably intelligent person could look at the CDC’s overdose numbers and not notice that overdoses are driven by illicit fentanyl, not prescription medication. Continue reading
Why the Disease Definition of Addiction Does Far More Harm Than Good – By Marc Lewis on February 9, 2018
Over the past year and a half, Scientific American has published a number of fine articles arguing that addiction is not a disease, that drugs are not the cause of addiction, and that social and societal factors are fundamental contributors to opioid addiction in general and the overdose crisis in particular.
The dominant view, that addiction is a disease resulting from drug use, is gradually being eroded by these and other incisive critiques. Continue reading
Opioid drugs: a comparative survey of therapeutic and “street” use. – PubMed – NCBI Pain Med. 2001 Sep
The conflation of opioid dependence and opioid addiction in the DSM 5 seems almost intended to recategorize chronic pain patients as addicts (in need of the recovery industry’s unregulated and ineffective, but highly recommended, “programs”).
The prescription of strong opioid analgesics for chronic non-cancer pain (CNCP) is described as controversial and can result in misidentification of patients as drug abusers or individuals with an addiction.
This study compared the effects of opioid drugs on CNCP patients and “street” users. Continue reading
America has to get its head out of the sand for the opioid epidemic by Brooke M. Feldman, MSW Candidate, University of Pennsylvania, Social justice activist – Oct 2017
America has a long history of rewriting its own history. While this practice is sadly nothing new, perhaps one of the greatest real time showings of it in my lifetime has been the false narrative being spread like wildfire around the “opioid epidemic.”
It goes something like this:
“Johnny is from a white middle class community. He had everything going for him…Johnny was prescribed narcotic pain medication by an irresponsible doctor peddling a nefarious pharmaceutical company’s wares. Unknowingly, Johnny got hooked and eventually moved onto using heroin. ” Continue reading
Chronic Pain, Chronic Opioid Addiction: a Complex Nexus – free full-text /PMC4781803/ – J Med Toxicol. 2016 Mar
Opioid therapy is regarded as necessary in the treatment of acute pain, such as post-operative pain.
Chronic opioid therapy (COT) is often utilized in palliative care and cancer pain paradigms.
However, COT remains controversial for the treatment of chronic non-cancer pain (CNCP), which often leads to physical dependence and may resemble an addictive disorder. Continue reading
Opioid Crisis: Efforts to Curtail Prescribing Are Backfiring | National Review | by Jeffrey A. Singer – October 25, 2017
This is noteworthy because it is published in a conservative magazine, which usually does little questioning of hard-line “law & order” policies.
For years now, federal and state authorities have focused on the supply side of the problem, targeting prescription-drug producers and providers.
But new information suggests that this approach is driving opioid abusers away from illegally obtained prescription opioids and towards heroin, fentanyl, and mixtures of the two.
And this is increasing the death rate from drug abuse. Continue reading
Underlying Factors in Drug Overdose Deaths | Substance Use and Addictive Disorders | JAMA | The JAMA Network – October 11, 2017
JAMA Viewpoint: Deborah Dowell, MD, MPH; Rita K. Noonan, PhD; Debra Houry, MD, MPH
This is the “viewpoint” of the very influential Dr. Houry, the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC, who has been instrumental in restricting prescription opioids.
Since 2010, overdose deaths involving predominantly illicit opioids (heroin, synthetic nonmethadone opioids, or both) have increased by more than 200% (Figure).
Chronic pain and opioid misuse: a review of reviews – Open Access (free full-text) – August 2017
The review found a high rate of pre-existing pain among non-medical Rx opioid users and found only a low level of opioid use disorder among pain patients.
The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse.
A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Continue reading
What Science Says To Do If Your Loved One Has An Opioid Addiction | FiveThirtyEight – by Maia Szalavitz
This is a well-referenced article providing an overview of the latest scientific understanding of opioid addiction – and the data show that pain patients are NOT likely to be addicted to their opioid medication.
Much of the advice given by treatment groups and programs ignores what the data say in a similar way that anti-vaccination or climate skeptic websites ignore science
The addictions field is neither adequately regulated nor effectively overseen.
“There’s nothing professional about it,
and it’s not evidence-based,” Continue reading
Remarkable Increases in Alcohol Use Disorders | Psychiatry | JAMA Psychiatry | The JAMA Network
The root problem of the “overdose crisis” is not opioids, but addiction in general, which can also manifest with alcohol:
This issue of JAMA Psychiatry includes a timely article by Grant et al that makes a compelling case that the United States is facing a crisis with alcohol use, one that is currently costly and about to get worse.
The article reminds us that the chilling increases in opioid-related deaths reflect a broader issue regarding additional substance-related problems.