The Price Of Pain Part 1

By: Kathleen Gramzay Friday April 15, 2016 comments Tags: opioid addiction, opioidadditionepidemic, pain relief, painkillers, painreliefwithoutdrugs

In this series, I will be sharing information about the current models for dealing with pain and the costs they wrest from individuals, families, and society as a whole.

Twice in the same week, I have happened across radio stories of the current epidemic of drug addiction in the U.S.  Neither was about the stereotypical heroin addict seen in TV dramas and movies.  The subject was pain and the conversation revolved around prescription opioid addiction.  On June 5, 2017, just 14 months after the original post of this blog, the matter is highlighted closer to home.  The Arizona Governor has proclaimed a statewide health emergency regarding the 16% increase deaths due to opioid overdose in 2016. Of the 790 deaths, 482 were from prescription opioids and 308 from heroin.  Since 2012, Arizona has seen a 70% increase in deaths from opioid overdose.

Opioids like oxycodone, dilaudid, demerol are prescribed regularly for moderate to severe pain. Percocet, the brand name for acetaminophen and oxycodone is the most commonly prescribed painkiller.   

While they can seem a Godsend when recovering from surgery, a severe injury or to combat chronic pain, the long term use effects can be devastating or potentially fatal.  

Opioids work by binding to the body's opioid receptors in the brain, spinal cord, and other areas and reduce the pain signals to the brain and the perception/feeling of pain. 

There are two aspects that create the potential for a very slippery slope.  

First, the body builds up a tolerance to opioids which then requires greater qualities of the drug to get the same effect.  It is important to note that with the introduction of external opioid sources, the body's own natural internal opioid production system wanes. Second, opioids trigger the release of the neurotransmitter dopamine in the limbic brain which regulates emotions such as pleasures of sex, eating or drinking, which is why opioids can become so physically and psychologically addicting.  

Over time, the body develops a hypersensitivity to opioids that continues after someone has stopped taking them.  As a result, the body has a much lower tolerance for opioids going forward.

This explains why fatal overdose is so common in those who relapse after a period of abstinence, thinking that the body can tolerate the levels is had previously grown to handle.

Since at least 2011, articles have been discussing this issue as a national epidemic. According to the National Institute on Drugs, there is a wide addiction age range from 12 to 80 years old, with 45-55 year-olds having the greatest number of deaths due to overdose. 

A Report to Congress this January 2016 by the National Institute of Health reveals sobering statistics of the alarming situation:

•    Of the 21.5 million Americans that had a substance use disorder in 2014, 2.1 million had a substance use disorder involving prescription pain relievers and 586,000 had a substance use disorder involving heroin.
 
•    Drug overdose is the leading cause of accidental death in the US, with 47,055 lethal drug overdoses in 2014 of which 18,893 (40%) overdose deaths were related to prescription pain relievers. 

In my previous blog post 5 Myths of Pain, I cite statistics on the increased television advertising dollars spent by pharmaceutical companies directly to the public, as well as marketing directly to doctors.

The NIH report cites several factors as likely to contribute to the epidemic: 

•    drastic increases in the number of prescriptions written and dispensed
•    greater social acceptability for using medications for different purposes and
•    aggressive marketing by pharmaceutical companies

The American Society of Addiction Medicine's 2016 Facts and Figures offers these statistics:

•    From 1999 to 2008, overdose death rates, sales and substance use disorder treatment admissions related to prescription pain relievers increased in parallel. The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999, and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

•     In 2012, 259 million prescriptions were written for opioids - more than enough to give every American adult their own bottle of pills.    

Particularly disturbing is that two factors contribute to the jump from prescription opioids addiction to heroin addiction - cost and availability.  

•    Four out of five new heroin users started out misusing prescription painkillers; and
•    94% of a 2014 survey of people in treatment for opioid addiction said they use heroin because prescription drugs were "far more expensive and harder to obtain"

The pharmaceutical companies' response is to race to see who can make time-released formulas more tamper proof and bring it to market the quickest.  According to Cowen & Co., opioid pain reliever sales  are expected to increase additional 15% up to $8.4 Billion by 2017.

I'm not saying it's not a smart idea to make time-released capsules more tamper-proof.  

I'm offering that maybe that's not the real problem that needs solving.  Maybe the underlying assumption that permeates our culture - that pharmaceuticals are the solution to pain - needs to be questioned. 

To continue to operate within a model that isn't working is to stay stuck in a paradigm that does not offer viable answers for true health and wellness and expect that it can because that's the message that is being sold. The definition of insanity is to do the same things over and over and expect a different result.  Sanity begins when you open the door to different ways of doing or being to get a different result.

In this continuing series, The Price of Pain, we'll look further at this subject and open the door to a different paradigm.

To your great health & well-being,

Kathleen

My mission with this blog is to provide information that supports holistic pain relief and self-care that encompasses all of who you are - body, mind, and Spirit.

About the Author: Kathleen Gramzay

Kathleen Gramzay, BCTMB is an 18-yr Board Certified Massage Therapist, Wellness Educator, Speaker & Developer of Kinessage® Self Care.  Her mission is to empower people to release stress, chronic tension & pain to live more joyful, productive lives.   If you would like to learn more about Kinessage® Self-Care or the Mindful Resilience programs, contact Kathleen




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