Opioid painkillers like Vicodin, Percocet and OxyContin currently top the list of the most prescribed drugs in the United States. Are that many Americans in need of such strong pain management? Are American expectations about pain control unreasonable? Do pharmaceutical companies bear any responsibility for the current prescription drug crisis? Are these drugs safe to take long-term? The questions surrounding the rise in opioid addiction abound.
Three physicians in California are speaking out to their peers, asking them to halt the tide of prescription drug addiction and overdose. Their solution? Stop writing so many prescriptions. The doctors voiced their concern in an editorial published in the Archives of Internal Medicine.
The doctors lay out their case with statistics and ardor. They say that 20 percent of all doctor visits end up with the patient receiving a prescription for opioids. Furthermore, they say that 20 to 40 percent of U.S. adults report chronic pain unrelated to cancer. By far the most common treatment for those pain complaints is opioid drugs.
The trio says that not enough research has been done to look into the effects of long-term opioid use but plenty of evidence is available relative to the harm the drugs can do. One glaring example is the number of opioid-related deaths. More Americans die from opioid overdose than from heroin and cocaine combined – around 12,000 deaths per year.
The California physicians agree that most doctors prescribe opioids in an effort to improve a patient’s quality of life. They disagree as to whether opioids are the best tool for managing long-term pain. They suggest that opioids should be reserved for short-term pain control.
Chronic non-cancer pain management would be better served with education and non-pharmaceutical options, they say. The doctors suggest that many patients need to be brought to an understanding that pain management rather than pain elimination is the appropriate long-term goal. For many patients, they would prefer to prescribe exercise and physical therapy.
The American Pain Society disagrees on a number of points and has commented publicly on the physicians’ editorial. Doctors associated with the Society are not ready to throw opioids under the bus. One physician, speaking on behalf of the Society, made it plain that doctors ought to be evaluating a patient’s risk of addiction prior to prescribing opioids and then have a further responsibility to monitor patients who warrant the drugs.
Nonetheless, an American Pain Society doctor said that, in fact, there have been longer term observational studies and clinical trials and all evidence thus far says that opioids are effective in the treatment of pain for some patients. Low-risk elderly women with severe arthritis were given as an example of the type of patient who safely benefits from opioid treatment.
Prescription painkillers are being abused at a rate that calls for national attention. Stories have been splashed across the front pages of newspapers and news magazines, and articles encouraging restraint have appeared in many professional health care journals. Whether or not opioids deserve the broad brush elimination suggested by these California physicians is yet to be determined.
28 Sep 2011
We’ve always known that drug abuse can kill, but a recent report from the Centers for Disease Control and Prevention shows that drug overdoses have surpassed car accidents in the number of deaths each year. That means 100 people die every day from drug overdoses, amounting to nearly 37,500 people in 2009 alone.
There are events from your past that trouble you, and you’ve noticed some unhealthy behavior patterns emerging – but how do you know if your struggles have been caused by emotional trauma or something else? Research shows that a number of relatively common experiences, such as car accidents, being diagnosed with a health condition, a significant break-up, or a deeply embarrassing or disappointing experience, can result in emotional trauma.
12-Step or “self-help” programs consist of anonymous groups of people who get together to support each other in sobriety. The most popular of these programs, Alcoholics Anonymous (“AA”), is also the oldest and serves as a template for offshoots such as Narcotics Anonymous and Overeaters Anonymous. Underlying AA is the belief that 12 steps need to be taken in order for an individual to remain sober. Although not associated with any particular religion, there is a spiritual aspect of the program that has been modified over the years to accommodate those participants who are adverse to the religious connotations.
16 Sep 2011
Some are using the beginning of the great recession in 2008 as a benchmark for increases in drug use in the United States. It is true that drug use in America has risen from 8 percent in 2008 to 8.9 percent in 2010, but the recent National Survey on Drug Use and Health does tuck some tidbits of good news in as well.
A Growing Epidemic of Marijuana and Prescription Drug Abuse
The national drug survey involved 675,000 adult Americans from across the country as a representative sample. Overall, the survey indicates that 22.6 million Americans use illegal drugs. It seems that what is driving the statistic higher is an increased use of marijuana, which has grown from 14.4 million users in 2007 to 17.4 million users in 2010.
There is a potential link between new state laws that permit the medical use of marijuana and the observed increases. More research needs to be done in order to establish the connection with certainty. What is known is that the fastest growing demographic for marijuana use is adults aged 18-25 years. Marijuana use in that age group was 19.6 percent in 2008, but by 2010 it had risen to 21.5 percent. The news is disconcerting given the fact that this is a period of life when most young adults are establishing the foundations for their futures – going to college, starting a career and building a family.
Marijuana is not the only growing drug problem. Illegal use of prescription painkillers is also on the rise. Sadly, most abusers of prescription painkillers obtain them not from the Internet (less than 1 percent), nor from drug dealers (around 4 percent), but from close friends and family members (55 percent).
Waning Abuse of Meth, Cocaine & Other Drugs
The good news is that methamphetamine use is waning significantly from the 735,000 users in 2006 to 353,000 users in 2010. Also moving in a positive direction is the downward trend in cocaine use from 2.4 million in 2006 to 1.5 million in 2010. Further good news is found in the smaller numbers of teenagers abusing alcohol and tobacco. The figures reveal teen drinking was at 14.7 percent in 2009, falling to 13.6 percent by 2010, while teen smoking decreased from 11.6 percent in 2009 to just over 10 percent in 2010.
Unfortunately, not many who abuse these drugs ever get the help they need. It is estimated that 23.1 million Americans need of professional drug rehab treatment, yet only 2.6 million Americans are getting help. When Americans do seek professional help, it is usually for alcohol abuse (#1 reason for seeking treatment), followed by treatment for marijuana abuse (#2). This used to be followed by treatment for cocaine abuse, but now the #3 reason for seeking drug treatment is abuse of prescription painkillers and/or heroin abuse.
In the current cultural climate, it is unacceptable to smoke almost anywhere. Why we don’t feel the same about alcohol and marijuana use is a question that deserves to be answered. Our own national survey is telling us that we have a serious problem we are not facing.
September is Recovery Month and for many recovering addicts, new Web-based support groups will help them have a greater chance of maintaining abstinence. The recent study conducted by Hazelden announced a new Web access program that is tailored to fit the needs and provide clinical information, as well as support, to patients over an 18-month period after their release from drug rehab.
An article in Market Watch tells how patients have access to addiction coaches to aid in their recovery and that those who fully engaged in the Web-based program throughout the year after their addiction treatment were much more successful in abstaining from alcohol and drugs than those who did not complete the program.
The preliminary findings of this study show that support programs like these on the Web can make a big difference for those in early recovery. Addiction is a chronic disease and just like those with diabetes or heart disease, addiction must be managed, monitored and continually treated throughout a person’s lifetime.
There is still much to learn about addiction treatment and recovery but this study demonstrates the need for more disease management tools and also more creative services. Hazelden conducted this study through their research arm.
When a partner or spouse gets violent, the physical damage is often visible and obvious. More difficult to detect, however, are the emotional wounds inflicted on the victim, with mental health disorders often resulting from trauma suffered in the home from a spouse.
11 Sep 2011
Previous research has shown that many of the same brain functions activated in those with drug addictions are similar to those who struggle with disordered eating behaviors. Reward receptors seem to be malfunctioning when people are addicted to substances that are associated with the release of dopamine in the brain.