By Janice Barlow with Richard Cameron
No one should doubt that we’re still
in the midst of an opioid crisis and have been for the better part of a decade. The nature of the crisis, however, is not what you have been led to believe by mass media reports and federal authorities.
Opioid medications have been part of treatment regimens for several decades. But in recent years, the line between who needs them to alleviate chronic or acute pain and who wants them because of the pleasant side effects, has become blurred. Or at least it has, according to the government.
Instead of creating a simple and organized process by which these medications, which are Schedule II opioid painkillers, including oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine, codeine, and fentanyl, can be dispensed to those who truly require them – each state has developed a convoluted process that keeps these medications away from the people who need them the most, just so it can claim it is keeping them out of the hands of abusers.
The Center for Disease Control has developed guidelines that make it very difficult for someone with a chronic and verifiable condition to receive a new prescription or an increased dose of a regulated medication. If you are a doctor who has a patient suffering from acute pain and you prescribe anything over 90 mg. of this class of substances (based on the daily equivalent dosage of morphine) – you will be exposed to a higher degree of scrutiny from authorities. This produces a chilling effect on the very medical providers that know and understand the circumstances and medical history of the patient best.
You might be asking, “but aren’t doctors massively over-prescribing pain relievers?” The answer runs contrary to many popular media narratives – and the answer is no. There was a statistical uptick in prescriptions during the last 30 years – that is true. But what is not understood, is that the increase in prescriptions was due to the severe underprescription of opioids prior to the 1980s. Prior to that, people who had severe pain were often denied drugs that provided meaningful relief. The prescription end of the opioid crisis is not the prime focus of the epidemic.
German Lopez, writing in Vox, outlines the dangerous unintended consequences of these policies of government overreach:
“When it comes to cracking down on opioids, just going after the drug’s supply isn’t enough. If you go after opioid painkillers, people will eventually go to heroin. If you go after heroin, they’ll eventually go to fentanyl. And if you go after fentanyl, they might resort to some of its analogs, like carfentanil. This drug crisis, then, likely requires a response that also tackles the existing demand for these drugs, particularly through new forms of drug prevention and treatment that can get people off these dangerous substances altogether.”
It seems that in the run for cover over reaction to the serious crisis of misuse of these controlled substances, federal and state authorities have drawn the overarching conclusion that anyone taking these medications will automatically become addicted to them and require rehabilitation. This is not the case in reality.
What is happening instead is that people who are truly suffering and in need of the relief that can only be attained with some of these medications, are being denied because there is a segment of the population that abuses them. It is odd that fentanyl is grouped in with the oral medication as it is a patch, and it’s very strong. Fentanyl is very deadly if used improperly. Some people have stupidly chewed them and died as a result.
Morphine is also far more volatile and dangerous than hydrocodone. It is just another example of the government lumping diverse products under one umbrella. It’s almost the same as saying that no diabetic should be allowed access to candy bars because some diabetics just eat too many of them and cause severe damage to their health.
The D.E.A. (Drug Enforcement Agency), the arm of government that has been perpetually administrating the failed “War On Drugs”, has produced new restrictions that are having a detrimental impact on chronic pain sufferers. The National Fibromyalgia and Chronic Pain Association (NFMCPA) released a survey assessing the first 100 days after the regulatory change. The results include:
- 88 percent of patients responding that the changes denied their rights to access pain medication.
- 71 percent report being switched to less effective medications by their doctors, who are fearful of legal issues.
- 52 percent perceiving an increase sense of stigma as a patient receiving hydrocodone.
- 27 percent of patients even reported suicidal thoughts when unable to access their prescription.
Among the comments received by the sponsors of this study, was the following. “The one person I know who says the recent guidelines have helped (is) my neighbor who is a heroin dealer. He says business has quadrupled since doctors have started becoming too afraid to help people in pain.”
The survey findings also strongly suggest that the over-reaction of public officials is driving an expansion of the black market in Schedule II substances, as typified by this respondent’s observation:
“I found it easier to get medications through the black market than through my doctor. I spend about $1,000 per month in medications through the black market, but in the end that is less than the deductible on my insurance. And they deliver to my house!”
It does go without saying that yes, some people have become unwittingly addicted to opioid medications. One reason is because they were over-dispensed for conditions for which they were not required. Giving a nineteen-year-old 30 hydrocodone (Vicodin) tablets because he had four wisdom teeth pulled is irresponsible. No opioid is generally needed for that kind of pain relief – and certainly not on an extended basis. But this sort of occurrence is a marginal aspect of the overall problem – and there are effective solutions to managing patient use of opioids, readily available and waiting to be implemented.
Conversely, denying someone ten days of hydrocodone who had a knee replacement to recover from post-surgical pain is also irresponsible. That is debilitating pain and would require more than a couple Advil.
The protocol now however, is often no more than three to five days of pain medication following major surgery, including heart surgery!
Chronic pain suffers are now being denied the hydrocodone, which is the most mild acting of the opioid drugs. The side effects are minimal, and the addiction patterns are not widespread. However, taking people off the medication that has helped alleviate pain for years has caused severe depression, return of chronic pain, and even suicidal thoughts.
And more than merely suicidal thoughts – real deaths of people driven to desperation by being deprived of adequate dosages of pain relieving medication, have been documented to be widespread.
Were there unscrupulous individuals with medical licenses operating clinics as a front to provide people using opioids for non-pain related purposes? There is no questioning that fact.
Joe Rannazzisi, former director of the DEA’s Office of Diversion Control, which regulates and investigates the pharmaceutical industry, told Bill Whitaker on CBS’ 60 Minutes that, “Pain clinics overnight popping-up – off an entrance ramp, or an exit ramp on an interstate. And all of a sudden there’s a pain clinic there. These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.”
Unfortunately, the government’s efforts in cracking down on bad players – rogue clinics and irresponsible, profit driven distribution networks, has bled over into the rights of individuals legitimately needing opioids. Ken McKim at Pain News Network, draws a remarkable and thought provoking analogy of how the epidemic of deaths related to auto accidents would be dealt with if managed by the CDC and DEA.
According to the most recent data from the National Institute of Health (NIH), there are an estimated 23.4 million Americans that suffer severe and chronic pain. In comparison to that number, it is estimated that less than 10 percent of those with chronic pain using opioids, are experiencing addiction symptoms.
When government agencies acting with the acquiescence of Congress, take a sledgehammer to a nail, scores of innocent people suffer.
Remarkably, the very government official who spearheaded the new CDC guidelines that are putting millions of Americans at risk, acknowledges that prescription opioids are not driving the public health crisis. Debra Houry, MD, Director of the CDC’s National Center for Injury Prevention and Control, admitted to House members in a Congressional hearing last year that:
“Although prescription opioids were driving the increase in overdose deaths for many years, more recently, the large increase in overdose deaths has been due mainly to increases in heroin and synthetic opioid overdose deaths, not prescription opioids. Importantly, the available data indicate these increases are largely due to illicitly manufactured fentanyl.”
Despite knowing the reality, Houry steadfastly refuses to reverse course.
No doubt, there are some of you reading this, thinking “everyone who becomes addicted to opioids and obtains them illegally, should get dealt severely by the criminal justice system – to hell with all these namby pamby drug treatment diversion programs!”.
You view others who fall prey to addiction as moral weaklings. That is a viewpoint shared by none other than “conservative” right wing icon, Rush Limbaugh, who opined in 2011 that:
“I’m appalled at people who simply want to look at this abhorrent behavior and say, ‘Hey, you know, we can’t control it anymore. People are going to do drugs anyway. Let’s legalize it.’ It’s a dumb idea. It’s a rotten idea, and those who are for it are purely, 100% selfish.”
Yes, that is that very same Rush Limbaugh, who seems to conveniently forget that he was engaged in what he describes in the above quote as “abhorrent behavior”, just 12 years prior. This is the man that abused not only the drugs, but the system itself to go ‘prescription shopping’ to satisfy his addiction.
And it’s the same Rush Limbaugh who received the most lenient celebrity justice, light tap on the wrist possible – a single charge, $3,000 bail, not a single day in jail and an 18 month probation. Limbaugh had obtained a cornucopia of feel good pills, including, according to court records – OxyContin, Lorcet, Norco, Hydrocodone, and Kadian.
“Average Joe” could have been convicted of the felony charge and sentenced to up to five years in prison for the same offense that Limbaugh got preferential treatment from the courts on.
Your “100% selfish” hard core anti-drug warrior, Limbaugh, even refused to confess his behavior to his radio listeners (despite copping a plea), saying cynically afterwards:
“From my point of view, the end result will be as if I had gone to court and won, but the matter is concluded much sooner,” Limbaugh told his listeners. “I have spent thousands of hours and millions of dollars with lawyers over the past 27 months fighting this at every stage.”
Limbaugh, incidentally was ordered to submit to … you guessed it, a drug treatment program – and the program, by all accounts, was successful. During Limbaugh’s 18 months of probation and rehab program, other non-politically connected men and women who committed the same crime, were occupying prison cells.
On September 18th, there will be a nationwide protest rally against the over regulation of pain medications.
In attendance will be people who have chronic conditions and have either been cut off from their prescriptions or diverted to one that is not effective, such as Tramadol (shown right), which has some pretty bad side effects.
Other people affected by the revised regulations, include people in the Medicare system who have had their prescriptions cut back, or been denied effective pain relief prescriptions for documented chronic conditions.
“We are protesting to have our voices heard regarding the neglect the chronically ill community/pain patients have experienced due to the new CDC guidelines, the DEA, and the FDA’s involvement.”
Interested parties can check get more information on the Facebook group, Don’t Punish Pain Rally, and search for their individual states in the Files section.