By Dr. Mercola
Yesterday I wrote that preventable medical errors and drug side effects are the third leading cause of death in the U.S. I've also written numerous articles about the dangers of opioid painkillers in particular.
While most drugs come with a long list of potentially devastating side effects, painkillers tend to be among the most lethal, in large part due to their addictive nature.
Prescriptions for opioid painkillers have risen by 300 percent over the past 10 years,1 and deaths from overdosing on these drugs now far surpass those from illicit street drugs. Sadly, legendary musician Prince appears to be yet another victim of the opioid epidemic.2
Prince Made Emergency Appointment With Addiction Specialist
It has now come to light that the 911 call from Prince's Paisley Park estate was made by Andrew Kornfeld, son of Dr. Howard Kornfeld, who runs an addiction clinic in California, specializing in opioid painkiller addiction.3,4,5
Kornfeld is said to have been summoned for an emergency consultation with Prince following an overdose of Percocet, mere days before his untimely death.6 Prince was reportedly taking the drug to manage pain associated with a chronic hip problem.
Unfortunately, by the time Kornfeld's son showed up for his appointment with the star, Prince was already dead.
Part of Kornfeld's treatment plan for painkiller addicts includes the use of an alternative painkiller buprenorphine7 (sold under the names Suboxone, Subutex, Zubsolv, and Bunavail), which he says can relieve pain with fewer risks than other opioids.
White House Supports Expanding Use of Gentler, Less Addictive Opioid
According to STAT, an online health newsletter,8 buprenorphine "is effective in treating both chronic pain and withdrawal because it's less likely to cause euphoric highs or overdoses and because withdrawal from it is gentler than with opioids."
While buprenorphine has been notoriously difficult to get, President Obama has proposed increasing the use of this drug to combat growing addiction rates.9 The drug is heavily regulated, and doctors initially had to take an eight-hour training course in the use of the drug before they were allowed to prescribe it.
According to STAT: "The White House wants to double the number of doctors certified to prescribe buprenorphine and is even considering allowing non-physicians to prescribe the drug." Opponents worry that the drug may end up being overprescribed by doctors without expertise in addiction.
Ironically, this kind of inexperience is in part why we now have such an epidemic of opioid abuse. As noted by Forbes,10 the recommendation to enforce mandatory training for doctors prescribing opioids has been brought forth more than once.
The Food and Drug Administration (FDA) rejected the training mandate in large part because the American Medical Association (AMA) lobbied against it.
But in light of the growing epidemic of abuse, it seems quite clear that many doctors do not have the prerequisite understanding to safely prescribe opioid painkillers, often underestimating their addictive nature and the risks for lethal overdosing.
Training for opioid prescribers is now being considered yet again, and a spokesperson has indicated that the FDA will now support it.11 An expert panel is expected to issue recommendations to the FDA sometime in the near future.
Doctors Unwilling to Take Responsibility for Their Role in Opioid Epidemic
Strangely enough, the AMA is even opposed to laws that would require prescribing doctors to check databases before issuing a prescription for a narcotic painkiller, to ensure the patient is not receiving the same or similar prescription from another doctor. According to The New York Times:12
"Doctors say measures like checking prescription databases take up more time in days already filled with bureaucratic duties, and many express ideological concerns about government's reach into medicine.
[E]xperts say many doctors believe that their practices and their patients are not responsible for the opioid problem."
If the problem was not created by prescribing doctors (recall prescriptions for opioids have surged 300 percent in the last decade), then who's to blame for the current scourge of opioid addiction and deaths?
Americans use the most opioids of any nation — twice the amount used by Canadians, who come in second place in terms of prescriptions. In Alabama, which has the highest opioid prescription rate in the U.S., there are 143 prescriptions for every 100 people!13
Clearly doctors bear a significant responsibility for creating this situation. Surgeons also need to reevaluate current practices of routinely sending surgical patients home with a powerful painkiller, regardless of whether they really need it or not.14
Drug Companies Should Be Held Accountable
The drug companies that create and sell these drugs also shoulder a major part of the blame, and really should be held accountable — especially when lying about the benefits and risks of their drugs. As noted by the Organic Consumers Association:15
"Pharma fostered the opioid addiction epidemic in four ways. It introduced long-acting opioids like OxyContin that could be crushed and snorted, or shot for heroin-like highs.
Industry also changed pain condition guidelines so that opioids were the first choice in conditions like lower back pain — conditions that never used to justify prescribing opioids.
Pharma also pushed and promoted the long-term use of opioids though no studies show such use effective or safe according to respected medical groups, including the Cochrane Collection.
And finally, the industry misinformed doctors, patients and the public, claiming that only 'some' people become addicted to narcotics — when in fact narcotics are addictive, period.
In fact, until Pharma's opioid revival, narcotics were administered only after surgery, accidents and for palliative care in the chronic and terminally ill."
Legal Drug Highs Drive Heroin Addiction and Deaths
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Within a few years of its introduction, OxyContin had become one of the hottest street drugs available, with addicts chewing or snorting or injecting them for a high that users compare to heroin. In fact, from a chemical standpoint the two drugs are nearly identical, and OxyContin has been identified as a major gateway drug to heroin.
Not surprisingly, heroin deaths have increased by 45 percent over the past five years, as users resort to heroin when they can no longer get a refill on their prescription. Price is also a factor, as heroin is cheaper. There's also an increased supply of heroin these days.
Dr. Meryl Nass, an internist who blogs about important health issues, has pointed out that opium production in Afghanistan has doubled since the U.S. military entered the region in 2001, and heroin-related deaths began to rise in 2002. She believes this is the real story behind the rise in heroin availability across the U.S.16
Canadian pain specialist Dr. Phil Berger previously summed up the "perfect storm" of malfeasance that created this public health disaster, calling it a:
"[C]onfluence of unbelievably aggressive marketing by the pharmaceutical industry that sells these drugs, plus the inadequacy of education to medical students and physicians in training and the utter failure of regulatory bodies, the Colleges of Physicians and Surgeons, to reign in their membership and provide proper oversight to how their members are prescribing medications."
Opioid Addiction Is Also Fueling Infectious Disease Rates
Along with deadly overdoses, painkiller and heroin addiction has also led to significant increases in hepatitis C and HIV, both of which are spread through the sharing of infected injection needles. According to the CDC,17 rates of acute hepatitis C infection in Kentucky, Tennessee, Virginia, and West Virginia have skyrocketed, increasing 364 percent between 2006 and 2012.
And while hepatitis C is treatable, the cost of the medication is high, running between $80,000 and $120,000 for a full treatment course. In 2014, hepatitis C-related deaths in the U.S. surpassed the total combined deaths from 60 other infectious diseases, including HIV, pneumococcal disease and tuberculosis!18 According to The Atlantic:19
"A national hepatitis C outbreak has been well documented. Last month, The New York Times reported that in Kentucky, 16,000 Medicaid recipients had a hepatitis C diagnosis last year, compared with only 8,000 the previous year ... Kentucky's rate of hepatitis C is more than seven times the national average, but the state spent 7 percent of its Medicaid budget treating only 861 people ...
'States have to prioritize treatment to those most in need. An exercise that would be wholly unnecessary if the cost were affordable,' [Matt Salo, executive director of the National Association of Medicaid Directors] wrote in an email. Generally, 'most in need' is defined as those who have already experienced liver function deterioration, with stage 3 or 4 liver fibrosis [being] the cutoff in most states, Salo said."
HIV is also making a comeback. The tiny town of Austin, Indiana recently became the unlikely epicenter of the largest HIV outbreak in U.S. history, courtesy of widespread opioid abuse.20 Multigenerational drug use is commonplace here, and out of a population of 4,100 individuals, an estimated 500 shoot up. Last year, Austin reported 180 cases of HIV, up from an average of three cases a year.
The Cycle of Addiction
OxyContin became a blockbuster drug mainly through misleading claims — claims Purdue Pharma knew were false from the start. The basic promise was that it provided pain relief for a full 12 hours; twice as long as generic drugs, giving patients "smooth and sustained pain control all day and all night."
However, for many the effects don't last anywhere near 12 hours, and once the drug wears off, painful withdrawal symptoms set in, including body aches, nausea and anxiety. These symptoms, in addition to the return of the original pain, quickly begin to feed the cycle of addiction.
Rather than prescribing more frequent doses, Purdue insists doctors prescribe higher doses instead, which makes the highs higher, and the lows lower. As noted by the LA Times:21
"Dr. Peter Przekop, a neuroscientist and physician who oversees the treatment of painkiller addicts at the Betty Ford Center ... said that repeated episodes of withdrawal from OxyContin 'absolutely' raise the risk that patients will abuse the medication. 'You are messing with those areas of the brain that are involved in addiction, and you are going to get the person dependent on it,' he said."
OxyContin Addiction Remains a Serious Problem
Since 1999, at least 190,000 people have died from OxyContin overdose.22 In 2007, Purdue Pharma pled guilty to charges of misbranding, and was fined $600 million for misleading the public about Oxycontin's addictive qualities.
A few years later, in 2014, Chicago and two California counties (Orange and Santa Clara) filed lawsuits against five OxyContin manufacturers, charging them with contributing to an epidemic of drug abuse by purposefully downplaying the risks of these drugs, overselling their benefits,23 and secretly funding front organizations, like the American Pain Foundation, to promote their widespread use.
Still the problem continues unabated. According to a nationwide analysis of prescription data, more than half of all long-term OxyContin users currently take doses considered "dangerously high" by public health officials.24 Fentanyl is also becoming increasingly problematic.
This synthetic opiate, originally used in hospitals for post-surgery pain, began showing up on the streets in 2014, mixed in with heroin.25 Traffickers sometimes sell pure fentanyl as heroin, and since this drug can be 50 times more potent than heroin, death can be swift.
Non-Drug Alternatives for Pain Relief
With all the health risks associated with opioid painkillers, you'd be wise to exhaust other options before resorting to these drugs. Below I list some of the most effective non-drug alternatives for the treatment of pain that I know of. If you're in pain, I recommend trying these first, before even thinking about prescription painkillers of any kind.
In the case of Prince, indictments may follow once authorities determine where the opioids found in his possession came from. But in the vast majority of cases, no one is penalized when a person dies from a prescription painkiller overdose.
A case can even be made that our federal government bears a responsibility in the current opioid epidemic, as policies support the use of these exceptionally dangerous painkillers while barring the use of medical marijuana, which can offer non-toxic pain relief.
Medical cannabis has a long history as a natural analgesic,26 and many states have legalized cannabis for medical purposes.
Its medicinal qualities are due to high amounts (about 10 to 20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids.
As discussed in this previous article, 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,27 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis and would certainly seem worth the effort for anyone with chronic pain to utilize.
Just be sure to seek out a knowledgeable cannabis physician, as many have no idea of the proper dosing.
If you are seriously considering medical cannabis for pain, it is imperative that you view my interview with Dr. Alan Frankel in this previous article, who is one of the leading medical cannabis physicians in the U.S.
He can do consultations on the phone if one needs specific questions answered.
✓ Eliminate or radically reduce processed foods
Avoiding processed grains and refined sugars (particularly fructose) 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 a 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 vitamin D level
Optimizing your vitamin D level by getting sensible sun exposure and taking a vitamin D3 supplement can help reduce pain via a variety of different mechanisms.
✓ Emotional Freedom Techniques (EFT)
EFT is a drug-free approach for pain management of all kinds. It 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 can help dissipate pain.
✓ K-Laser Class 4 Laser Therapy
K-Laser therapy 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 and 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. Phil Harrington.
✓ Avoid sitting
One of the most common causes of pain is low back pain. Even I struggled with it for many years. The only thing that eliminated it was radically reducing the number of hours I sit down from 15 hours a day to less than one.
Many studies have confirmed that chiropractic management is much safer and less expensive than allopathic medical treatments, especially when used for 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.
Research has discovered a "clear and robust" effect of acupuncture in the treatment of back, neck and shoulder pain, osteoarthritis, and headaches.
✓ Physical therapy and massage therapy
Both have been shown to be effective for painful conditions such as torn cartilage and arthritis.
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.
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.
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.28
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.
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.
✓ Mind-body techniques
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.