Nagging, unrelenting pain, the kind that colors every moment of life, is something you wouldn’t wish on your worst enemy. But what should be done when the relief for that pain becomes an enemy to both users and society at large?
A better way for physicians and patients to address chronic pain must be found. Clearly, the strategy of the last decade or so is having serious, if unintended bad consequences.
Self-inflicted overdoses of prescription painkillers are responsible for almost 15,000 deaths a year in the U.S. That death toll exceeds the combined deaths from heroin and cocaine overdoses. In some states, the public interest journalism group ProPublica reports, painkiller deaths exceed car crash deaths. The Centers for Disease Control and Prevention has labeled opioid drug overdoses an epidemic. Certainly, in parts of Maine, addiction to those drugs — Percocet, Vicodin and OxyContin — is at epidemic levels.
ProPublica found one smoking gun — the influence of the pharmaceutical-company funded advocacy group, the American Pain Foundation. But castigating an industry shill distracts from solving the problem. And it’s a problem whose solution ought to be within reach, if not grasp, because just about all the drugs that are sold and used illicitly can trace their existence to the tip of a doctor’s pen.
One less discussed factor in the painkiller dilemma is the 21st century American relationship with pain. In short, we don’t tolerate it. It hurts, and there ought to be a pill to make it go away.
Chronic pain is nothing to be dismissive about. Doctors shouldn’t tell the logger who shattered part of his spine to simply deal with the pain. The woman who suffers blinding headaches, also, shouldn’t be told think about something else. But the pendulum has swung too far toward total annihilation of pain.
Surveys of physicians a dozen years ago found that too many were withholding pain medication, including to terminally ill patients, because of fears that they might become addicted to morphine. The now-common query from emergency department docs rating pain on a number scale came out of the move for more responsive pain management.
But there are ways to manage, if not eliminate chronic pain that do not rely on a magic pill. They include therapies such as chiropractic, acupuncture, massage and even hypnosis and meditation. Natural, nonaddictive substances such as (prescribed) marijuana also can be used to ease some chronic pain.
The larger issue is the role pharmaceutical manufacturers and their media marketing campaigns and sales staff play. While OxyContin isn’t advertised on TV, every other pill that purports to solve every malady under the sun is. Physicians report patients ask them for prescriptions for pills they’ve seen advertised, and when told it doesn’t address any condition they have, they still demand it.
Some in Congress have proposed banning the direct-to-consumer marketing of prescription drugs. Every other industrialized nation (except New Zealand) bans such advertising.
Jerry Avorn, a physician and professor of medicine at Harvard and author of “Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs” writes that “Congress allocates the Food and Drug Administration about $2.4 billion per year to regulate our foods, drugs and cosmetics. Yet twice that amount is spent by the pharmaceutical industry on direct-to-consumer advertising of its ware. Something is very wrong here.”
Indeed. And the scourge of painkiller addiction and wrecked lives we see in Maine is part of what’s wrong.
WOW!! This is the gospel in this story! So what can we do about? Every one is getting greased by FAT CAT Farmies!! The world is full of sissys. everyone is either in pain or their feelings are hurt. look at all the rights the criminals have. Has anyone ever thought, life is suposed to be tough. Pain is virtue. we need to be strong. We live to be 80-90 so of coarse we are in pain! We are not ment to live that long, especially if we are weak.
Until we as a nation wake up to the reallity of big pharmas insatiable thirst for profits at any cost, this will continue to be a growing problem.
One thing this nation could do is to pay the tuition of student who wish to become doctors and form a national malpractice insurance plan. Doctors, by the time they graduate 8 years of college and usually 1 to 3 years of internship are stuck with a huge student loan to pay off. They then have to spend an inordinate amount of their income on malpractice insurance. Is it any wonder that they, being human, are easy prey to big pharma who want them to push their pills? I wonder if doctors would be so eager to prescribe meds if they weren’t under so much debt to start their carreers.
How do we put an end to children being prescribed an ever increasing amount of mood altering drugs? Most addicts are turned on at an early age and are convinced that if they aren’t medicated, they can’t function in society. Unfortunately they have no idea if they could, because they have never been allowed to find out what it is to have normal feelings and to cope with them.
How exactly are drug companies to blame for abuse of a drug like oxy that has very legitimate use, but is over-prescribed by doctors and abused by individuals. Because they have too much debt? Give me a break: have you seen the average salary of a physician? Did anyone force them to take on debt? Aren’t they grownups that know better than to enable drug abuse?
In fact, the article suggests that if we want to find a villain here, we need to look in the mirror. We demand a pill and a quick fix for everything, and the drug companies of course try to oblige. There’s a reason pain meds aren’t direct marketed: they sell themselves!
Well, you covered a lot of ground didn’t you Patom1.
1. Big pharmas do have an insatiable thirst for profit. That has nothing to do with controlling chronic pain other than that they develop a product to help. Yes, that research is profit driven. I have no problem with that. I do have a problem with them charging obscenely large amounts for their product.
2. Malpractice, and it’s cost to society, is overblown and being pushed upon us by the GOP as a reason for the high cost of healthcare. Want to lower the incidence of malpractice suits? Then the AMA has to stop being the entity that provides oversight to physicians. That’s like the fox watching the henhouse. You need to have the U.S. Dept of Health and Human Services regulating and providing oversight of the doctors. Bad doctors need to be eliminated from the system. The AMA NEVER stops a bad doctor from practicing unless they have done something incredibly heinous. Effective oversight will vastly cut down on the number of malpractice suits.
3. Student loans are large, no doubt about it. They are large for everyone not just doctors. I believe this is a legitimate complaint. To make this worse, aspiring doctors often go to the most expensive schools. They do this in anticipation of making the big bucks! Want to stop this? Adopt a national healthcare plan were everyone is covered as a part of our system of social services. Then “forgive” physicians their student debt for tuition at a normally priced school.
4. Want to stop children from being overmedicated. Be a parent!
Who wrote this, and why? What is different from, “The American Way of Pain,” and the Japanese way, the French way, or the Malaysian Way? Did the person who wrote this have chronic pain? Is their a prejudice against taking medication for pain, as if often the case in our culture when I grew up, where, NO PAIN, NO GAIN, comments are made by sports figures who later, turn out, to be using all sorts of drugs to enhance their performance?
President John F. Kennedy was awash in drugs as he managed our nation in the 1960s. At this web address, http://www.nytimes.com/2002/11/17/us/in-jfk-file-hidden-illness-pain-and-pills.html?pagewanted=all in the New York Times, it says, “But newly disclosed medical files covering the last eight years of Kennedy’s life, including X-rays and prescription records, show that he took painkillers, antianxiety agents, stimulants and sleeping pills, as well as hormones to keep him alive, with extra doses in times of stress., At times the president took as many as eight medications a day, says the historian, Robert Dallek.”
I’m asking, because people have used pain relievers ever since they could find them. You can buy government issued stamps for your stamp collection, which were put on barrels of pain reliever which were 98% alcohol and 2% heroin. Today, heroin in the form of oxycodone or other drugs is something called a problem, and illegal, if you don’t have a prescription, but you can buy all the ALCOHOL DRUGS you want in large quantities at Hannaford. And if you want some of the more sophisticated methods of pain relief, like chiropractic help, it costs money, and if you are poor, well, your Maine Care has just been denied.
I have been lucky enough to avoid chronic pain, and my personality is the type to avoid pain relievers, and try to adjust my activities to heal, or avoid more physical pain. Not all have this personality type, I guess. But I have benefitted greatly by psychiatric drugs that have allowed me to alleviate a lot of the psychiatric/emotional pain I usually have. So my feelings about pain relievers are mixed, and when I’ve had operations, I’ve definitely been very thankful for pain relievers and the people who ask about my pain level, and administer these drugs.
The person who wrote this editorial does not identity themselves, or their personal pain issues, or personal prejudices about pain and pain medications. I’m just wondering what’s been left out of this editorial?
I wish I knew some real answers to human existence, but even if I did, who would even listen….LOL I say this with a sense of humor. Everybody thinks they know the answers, but I guess each of us must find our own path in life.
Clearly, bath salts and drug/alcohol addiction are not the way to lead your life in regards to other people we encounter, but on the other hand, there is pain, something that disturbs and disrupts our lives (often leading to suicide or other results). So I ask the original question, “What is the American Way of Pain, as opposed to the French Way, the Armenian Way, or the Russian Way?”
Maybe true pain clinics are needed . In other words, unless you are elderly (70+) or terminally ill, you need to go to a pain clinic every day for your daily dose, just like a methadone clinic. But no take-homes for good behavior. The goal should be toward developing tolerance for a certain amount of pain and using non-medication ways to cope so that people will be off pain meds.
This may sound extreme but nothing else is working.
So people want a quick fix drug for everything, but drug companies are evil for providing it? If we want to understand the drug problem in America, legal or illegal, we need to look at the consumers. This is why the “war on drugs” has failed completely.
If you do not have a chronic pain there is no way you can understand. Chronic pain if not treated leads to depression that can happen even if it is treated. If there is ever a machine built where you could live in another body for a day then you could see. These drugs as with all drugs are abused by some but essential to others. Also due to those that abuse drugs those who require opiates for pain can not get three month supplies like other can with there meds. You need a NEW prescription every month and there are no refills by law on them. So those with chronic pain have to visit the doctor more an pay out more money also many having to do so in pain over distances in Maine to see the doctor.
End the prohibition on marijuana.
Right, because people who are on medicinal marijuana give up their opiates.
Not.