28 Nov 2017
Prescription Painkillers: A Cause For Concern?
Opioid abuse has increased in the past few years, due in part to misuse of prescribed pain medications. In the United States, opioid addiction is a serious public health issue, and many fear that the problem will extend to Latin America and the Caribbean.
Prescription painkillers have become a hot topic. Every day brings a new, different, headline either touting the benefits of painkillers or linking them to tragic stories of addiction. Faced with so much, often contradictory, information it can be hard to tell fact from fiction.
The official figures indicate that more than 300,000 people have died due to opioid overdose, including prescription medications and heroin, in the last sixteen years.
Why is the death rate so high? Part of the problem is the increasing abuse or misuse of prescribed opioids. In the last decade, prescriptions for drugs used to alleviate pain have increased by 300%. For instance, Vicodin - a semi-synthetic opioid that combines acetaminophen and hydrocodone - is one of the most frequently prescribed medications in the United States.
Looking at the statistics, it would be easy to conclude that Americans experience more pain than any other population in the world. Approximately 80 percent of the global opioid supply is consumed in the United States.
More than 30% of Americans suffer from some kind of acute or chronic pain. Among older adults chronic pain is more prevalent by over 40%. Given the high number of people suffering from the crippling effects of chronic pain, it’s not surprising that opioid painkillers are now the most prescribed type of medication in the United States.
But the opioid crisis is a scourge that threatens to extend to other countries. The latest report from the United Nations’ International Narcotics Control Board (INCB) warns about an increase in opioid drug prescriptions in Mexico.
From misuse to abuse
Although opioids are effective at alleviating certain kinds of pain, many people take them even if they’re not the most appropriate, or the safest drug for their condition(s). Even when taking an opioid is the right choice understanding how the drug works, and what the correct dosage is, is fundamental to avoiding serious side effects and addiction.
Heroin and opioid painkillers, including those prescribed by a doctor, affect the brain in very similar ways. Taking only a few doses of the drug, even as instructed by a doctor, can lead you to develop a tolerance for it. This means that you’ll need to increase either the size of the dose or the frequency in order to feel the drug’s effects.
Opioids are incredibly strong drugs so it’s important to be mindful of their potency. Taking someone else’s prescribed medication, combining it with other medicine, or taking too much of the drug at once can all be fatal mistakes.
Five myths about prescription painkillers
- The more you take, the better they work. More isn’t always better. It’s true that in the short term, following a serious injury or during a terminal illness such as cancer, two pills may be more effective than one. But the chronic use of painkillers sensitizes a portion of the nervous system and affects the way the brain and the spinal cord interpret pain signals.
- If they’re prescribed by a doctor, they can’t harm us. Assuming that prescription drugs are safer is wrong and dangerous. Even if the reason you start taking a painkiller is legitimate, you still run the risk of drug abuse and addiction.
There are several things we know with certainty. The first is that opioid painkillers are often used incorrectly, and their widespread use can lead to addiction, overdose, and death. Next, medical prescriptions are a significant source of opioid circulation. For these reasons, doctors and medical associations have started questioning the practice of prescribing opioids, particularly for the management of chronic pain. - There are no long-term consequences. The risks of taking pain medications are not limited to addiction. When consumed for long periods of time, these drugs can impact the endocrine system and modify hormone production, affecting everything from your libido to your risk of osteoporosis.
- Painkillers put an end to pain. These medications can only mask the symptoms, not treat the underlying cause of pain. It’s important to get a serious diagnosis and target the origin of pain whenever possible in order to eliminate it for good.
For long term pain, such as arthritis, lower back pain, or nerve pain, many studies show that non-opioid medication and even treatment without medication can often bring more relief and less risk.
- If I take painkillers, I can still drink alcohol on a daily basis. This is a grave misconception. Opioids, alcohol, and other medications such as sedatives, work by affecting the central nervous system. They make our minds foggy and slow down our breathing. Combining them can be deadly. Statistics show that most opioid-related deaths involve alcohol or other drugs.
Among the most dangerous medications to combine with opioids are benzodiazepines, which are used as anticonvulsants, anti-anxiety drugs, muscle relaxants and sedatives. Examples of benzodiazepines include alprazolam (Xanax and generic versions); clonazepam (Klonopin and generic versions); diazepam (Valium and generic versions); and lorazepam (Ativan and generic versions.)
If you are taking prescription painkillers, you should abstain when it comes to alcohol. And before taking an opioid medication, consult with your doctor and pharmacist to make sure it will not interact with other prescriptions, over the counter drugs, supplements, or herbal treatments that you might be taking.
Relieve pain without drugs
Pain can have a significant influence on the general health of an individual and can have serious consequences: poor nutrition, decreased appetite, abnormal sleep patterns, fatigue, and disruption of daily activities. It can cause psychological problems and contribute to a delay in recovery and healing of injuries and diseases. Pain affects the lives of more patients than diabetes, heart disease, and cancer combined.
Even so, in many cases it is possible to relieve pain without medication. More and more studies indicate that treatment without drugs, including exercise, lifestyle changes, behavioral therapy, acupuncture, and massage can be more helpful in reducing pain and improving quality of life.
Sources:
National Institute of Drug Abuse (NIDA); The Ochsner Journal; Surprising facts on prescription painkillers, Consumer Reports; Junta Internacional de Fiscalización de Estupefacientes (JIFE), Informe 2016. Naciones Unidas; Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies, The New England Journal of Medicine; Centers for Disease Control and Prevention (CDC); Cleveland Clinic; HolaDoctor.com