By Dr. Mercola
Pain, regardless of cause, is among the most common of health ailments. Unfortunately, Americans in particular are succumbing to drug addiction in record numbers as a result of short-sighted and financially-driven drug marketing.
More than 70 million prescriptions for non-steroidal anti-inflammatory drugs (NSAIDs) are written each year, and according to 2010 data,1 there were enough narcotic painkillers being prescribed in the US to medicate every single adult, around the clock, for a month.
By 2012, a whopping 259 million prescriptions for opioids and other narcotic painkillers were written in the US,2 which equates to 82.5 prescriptions for every 100 Americans. And those narcotics are responsible for 46 deaths each and every day...
Americans use the most opioids of any nation—twice the amount used by Canadians, who come in second place in terms of prescriptions.3 The problem has become noticeable enough that US officials now warn that narcotic painkillers are a driving force in the rise of substance abuse and lethal overdoses.
As noted by CDC Director Tom Frieden,4 narcotic painkillers are very dangerous medications: "Patients given just a single course may become addicted for life," he recently warned. I strongly recommend exhausting your options before resorting to a narcotic pain reliever, and I'll list a number of alternatives at the end of this article.
These drugs do have a place and it is a great benefit to have them as a resource, but it appears that they are clearly being abused by large numbers of people and the evidence suggests that it is likely the majority.
It's quite clear that these drugs are being overprescribed, and can easily lead you into addiction and other, more illicit drug use. I strongly suspect that the overreliance on them as a first line of defense for pain is a major part of this problem.
Prescription Rates Vary Widely by State
Prescription rates vary widely from state to state,5, 6 , 7 however. The most recent data by the US Centers for Disease Control and Prevention (CDC) clearly illustrates these discrepancies. As reported by Forbes:8
"Alabama tops the list of painkiller prescriptions, with 143 prescriptions for every 100 people. This startlingly high number is three times the amount in the lowest prescribing state, Hawaii.
The numbers don't look so encouraging, especially since overdose from prescription drugs continues to be a huge problem in the country. Luckily, though, when prescribing regulations tighten as they have in Florida, the death rate does seem to respond in kind."
As noted in the article, Florida clamped down on its prescription guidelines in 2010, in an effort to combat rampant "pill mills" that were little more than legal (and even not-so-legal) suppliers to junkies.
As a result, narcotic-related deaths in Florida declined by 23 percent over the next two years. Deaths from oxycodone, the most commonly abused drug, fell by a respectable 50 percent between 2010 and 2012.9
In 2012, New York State also enacted more stringent prescription rules for painkillers. There, doctors are required to access a state prescription-drug monitoring program before writing another prescription.
In the two years since, there's been a 75 percent reduction in patients seeing multiple doctors for the same drug.10
Still, there's plenty of room for improvement. Especially in states where prescription rates are highest, such as Tennessee, West Virginia, Alabama, Maine, and New Hampshire.
"We're not seeing consistent, effective, appropriate prescribing of painkillers across the nation, and this is a problem because of the deaths that result," Frieden said in a July 1 teleconference.11
"All states, but especially those whose prescribing rates are highest, need to examine whether the drugs are being used appropriately."
Chicago and Two California Counties Sue OxyContin Makers for Inciting Drug Abuse Epidemic
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In related news,12 Chicago and two California counties—Orange and Santa Clara—have filed a lawsuit against five drug companies that manufacture OxyContin, charging them with contributing to an epidemic of drug abuse. The two California counties are suing on behalf of the entire state. In Santa Clara County, the death rate for opioid overdoses has tripled in the last decade, and according to assistant County Counsel Danny Chou, this is all due to a "decades-long marketing plan" by drug companies "to create a market for these drugs that never should have existed" in the first place.
According to Chou, Santa Clara spends millions of dollars to treat overdoses and addiction in its public hospitals, and he wants the drug makers to pay for these costs—just like tobacco companies were forced to pay after being sued in the 1990s. The lawsuit accuses the drug companies of purposefully downplaying the risks of these drugs, and secretly funding front organizations, like the American Pain Foundation, to promote the use of painkillers. According to Chou:
"They're the ones who deceive the doctors about the risks and benefits of opioid drugs. And they also deceive patients who then demand these drugs from the doctors. Ultimately, I don't think that the problem could be resolved until doctors and patients get accurate information. You have to start at the source."
Front Groups Are Used to Deceive You
Interestingly, a 2011 Journal Sentinel/MedPage Today investigation13 discovered that a University of Wisconsin-based organization called Pain & Policy Studies Group—which had received $2.5 million from makers of painkillers over the past decade—had been a "national force" pushing for expanded use of opioids. This group has also warned against increasing regulations of these dangerous drugs. As reported by MedPage Today:14
"Doctors in the addiction and pain fields say the UW Pain Group pushed a pharmaceutical industry agenda not supported by rigorous science. 'They advocate for policies that benefit pharmaceutical companies and harm pain patients and the public health,' said Andrew Kolodny, MD, an expert on opioid addiction...
The efforts of the UW group helped create a climate that vastly expanded unproven medical use of the often abused drugs, said Kolodny, chairman of psychiatry at the Maimonides Medical Center in New York City. In addition, a review of records revealed personal financial relationships between drugmakers and two officials with the UW Pain Group. Those include helping a drug company win Food and Drug Administration approval for a new narcotic painkiller and working as speakers or consultants."
The largest funder of the UW Pain Group was Purdue Pharma, which donated about $1.6 million to the group. Purdue actually ended up having to pay fines and restitution payments to the tune of $635 million after the US Department of Justice accused the company of misleading doctors with fraudulent claims, back in 2007. The company promoted OxyContin as "less addictive, less likely to cause withdrawal, and less subject to abuse" compared to other pain medications—claims for which they had no proof.
According to the featured report, the UW Pain Group played a key role in the rapid growth of Oxycontin, which led to a scourge of addiction and death. Indeed, as noted by MedPage: "The narcotic painkiller industry's funding of the UW Pain Group is a unique twist on the drug and medical device industry's use of medical schools to sell more of its products, sometimes at the expense of patients."
Conflicts of Interest Must Be Taken Seriously
In 1996, the founder of the UW Pain Group, David Joranson, co-authored a consensus statement from the American Pain Society and the American Academy of Pain Medicine, which suggested that opioids were "safe and effective for chronic, noncancer pain and that the risk of addiction was low." Another co-author of this paper was J. David Haddox, DDS, MD, who was also a paid speaker for Purdue Pharma. (He was given an executive position with Purdue three years later.)
In 2002, Joranson and Haddox teamed up yet again, co-authoring a paper with a third UW Pain Group official, Aaron Gilson, PhD, in which they warned that regulatory scrutiny might do more harm than good, as it would hamper people's efforts to manage their pain. The paper did not disclose any of their conflicts of interest with Purdue and other drugmakers who would stand to gain from such advice. This is precisely why conflicts of interest are so dangerous, and why disclosure of such conflicts is so important.
Clearly, these three men were acting on behalf of an agenda, and the agenda was bought and paid for by pharmaceutical companies. Again and again, we see how front groups are created and craftily used to create the illusion of an independent consensus. There are countless such front groups serving as PR machines for virtually every major industry out there, but the pharmaceutical and chemical industries are probably in the lead. These front groups are integral for shaping and molding public opinion, by virtually any means, including corporate opinion masquerading as "science-based fact"—even after companies have been forced to pay fines for misleading claims!
As reported by MedPage15 in 2012:
"[T]he UW Pain group is just one link in a network of national organizations and researchers with financial connections to the makers of narcotic painkillers. Beginning 15 years ago, that network helped create a body of 'information' that today is found in prescribing guidelines, patient literature, position statements, books, and doctor education courses, all which favored drugs known as opioid analgesics.
Without rigorous scientific evidence to prove that their benefits outweigh potential harm, drugs like OxyContin and Vicodin increasingly have been used to treat a wide array of chronic pain syndromes including low back pain and fibromyalgia...
Over the past decade as many as 100,000 Americans have died from opioid overdoses and millions have become addicted to the drugs, said Andrew Kolodny, MD, a New York psychiatrist and opioid addiction specialist who co-founded Physicians for Responsible Opioid Prescribing. 'This is an out of control epidemic, not caused by a virus or a bacteria,' said Kolodny... 'This epidemic has been caused by a brilliant marketing campaign that dramatically changed the way physicians treat pain.'"
19 Non-Drug Solutions for Pain Relief
As I stated at the beginning, I strongly recommend exhausting other options before you resort to a narcotic pain reliever. The health risks associated with these drugs are great, and addiction is a very real concern. Below I list 19 non-drug alternatives for the treatment of pain. These options provide excellent pain relief without any of the health hazards that prescription (and even over-the-counter) painkillers carry. This list is in no way meant to represent the only approaches one can use. These are just some of the best strategies that I know of. If you are in pain, please try these first, before even thinking about prescription painkillers of any kind.
- Eliminate or radically reduce most grains and sugars from your diet. Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses.
- Take high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they manipulate prostaglandins.)
- Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.
- Emotional Freedom Technique (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain.
- K-Laser Class 4 Laser Therapy. If you suffer pain from an injury, arthritis, or other inflammation-based pain, I'd strongly encourage you to try out K-Laser therapy. It can be an excellent choice for many painful conditions, including acute injuries. By addressing the underlying cause of the pain, you will no longer need to rely on painkillers. K-Laser is a class 4 infrared laser therapy treatment that helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones.
The infrared wavelengths used in the K-Laser allow for targeting specific areas of your body, and can penetrate deeply into the body to reach areas such as your spine and hip. For more information about this groundbreaking technology, and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
- Chiropractic. Many studies have confirmed that chiropractic management is much safer and less expensive than allopathic medical treatments, especially when used for pain, such as low-back pain. Qualified chiropractic, osteopathic, and naturopathic physicians are reliable, as they have received extensive training in the management of musculoskeletal disorders during their course of graduate healthcare training, which lasts between four to six years. These health experts have comprehensive training in musculoskeletal management.
- Acupuncture can also effectively treat many kinds of pain. Research has discovered a "clear and robust" effect of acupuncture in the treatment of back, neck, and shoulder pain, osteoarthritis, and headaches.
- Physical and massage therapyhas been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
- Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses are typically required and you may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility.16 A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.17
- Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple, including some of the bromelain-rich stem, may also be helpful.
- Cetyl myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
- Evening primrose, black currant, and borage oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
- Medical cannabis has a long history as a natural analgesic.18 At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavanoids. As discussed in this previous post, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel "stoned"—and high in medicinal CBD. The Journal of Pain,19 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis.
- Methods such as yoga, Foundation Training, massage, meditation, hot and cold packs, and other mind-body techniques can also result in astonishing pain relief without any drugs.
- Grounding, or walking barefoot on the earth, may also provide a certain measure of pain relief by combating inflammation.