By Dr. Mercola
More than 28,000 Americans died from opioid overdoses in 2014 — more deaths than any other year on record, according to data from the U.S. Centers for Disease Control and Prevention (CDC).
The number includes deaths from both heroin and prescription opioid pain relievers, but the latter accounted for at least half.1,2 The epidemic, which, by the way, is the CDC’s own term for this increasingly alarming trend, appears to only be getting worse.
Since 1999, opioid overdose deaths quadrupled, as did the amount of prescription opioids sold in the U.S. All of these pain relievers did not equate to equal amounts of pain relief, however, as Americans reported pain levels stayed steady during that time.3
Meanwhile, death rates from overdoses of oxycodone, hydrocodone, methadone and other prescription opioids also quadrupled since 1999.4 In some areas, such deaths are becoming so commonplace they’re overwhelming coroner and medical examiner systems.
Some Areas Are Looking Into Renting Refrigerated Trucks to Store Bodies
In Connecticut, the chief medical examiner has considered renting a refrigerated truck to store bodies because the storage space at the medical examiner’s office is often maxed out.
The space shortage is attributed to rising drug overdose deaths, including opioid overdoses, which are pushing many medical examiner and coroner offices to their limits.
In areas like Cincinnati, Ohio, forensic pathologists responsible for conducting autopsies on many such victims may conduct more than 325 autopsies this year alone.
The National Association of Medical Examiners’ (NAME) accrediting program puts the limit at 325 a year, and offices that conduct more risk losing accreditation.
Some coroner’s offices are also facing backlogs of DNA testing for drug investigations, again in large part due to overdose deaths. Dr. David Fowler, Maryland’s chief medical examiner and president of NAME, told STAT News:5
“There are many, many parts of the country that have substantial problems … I think the drug overdoses have substantially increased the problems.”
Opioid Use Among Seniors Soars
The opioid epidemic has touched lives both young and old. A new report from the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) revealed that seniors take the drugs at an “astounding" rate.6
About 12 million Medicare beneficiaries, or about 1 in 3, received at least one opioid painkiller prescription in 2015, totaling $4.1 billion. Among those taking the drugs, most received more than one prescription or refill; the average was actually five opioid prescriptions or refills per opioid user.
The most popular opioid drugs among seniors include the commonly abused OxyContin, Percocet, Vicodin, fentanyl and generic equivalents. The study’s lead author noted concerns about the high rates of use as well as the potential for abuse.
Among seniors, the health risks of all medications are increased, because the body takes longer to break down and get rid of the drug than it does in a younger person.
As a result, the drug stays in an older person's system longer, where it can cause even greater damage. Seniors are also likely to be taking multiple medications, which raises the risk of drug interactions.
Long-Acting Opioids Increase Risk of Death
Close to 2 million Americans abused or were dependent on opioids in 2014, according to the CDC.7 Many of them got hooked after taking the drugs for chronic pain, such as low back pain.
About 1 out of 5 patients with non-cancer chronic pain or pain-related conditions are prescribed such drugs, the CDC stated, but they should be reserved as an absolute last resort.
Research published in The Journal of the American Medical Association (JAMA) even revealed that patients with non-cancer chronic pain (primarily back and other musculoskeletal pain) who took long-acting opioids were at an increased risk of premature death compared to patients taking other medications.8
The long-acting opioids not only increased patients’ risk of death from unintentional overdose, but also increased risk of death for any reason by 64 percent and risk of cardiovascular death by 65 percent.
Study author Wayne Ray, Ph.D., professor of health policy at Vanderbilt University School of Medicine, told the Epoch Times:9
“The take-home message for patients with the kinds of pain we studied is to avoid long-acting opioids whenever possible … We knew opioids increase the risk of overdose. However, opioids can interfere with breathing during the night, which can cause heart arrhythmias.
We were concerned that long-acting opioids might increase cardiovascular death risk, which is what we found.
Because most patient populations have more cardiovascular deaths than overdose deaths, our finding means that prior studies may have underestimated the harms of long-acting opioids.”
U.S. Heroin Use Reaches 20-Year High
Heroin addiction is fueled by legal drug addiction to opioid painkillers, which, from a chemical standpoint, are nearly identical to heroin.
Many painkiller addicts end up using heroin when their tolerance level surpasses their allotted prescription dosage or when they are no longer allowed to refill their prescription. Heroin is also typically much less expensive than prescription drugs.10
In fact, a joint report by the CDC and the U.S. Food and Drug Administration (FDA) revealed that the vast majority — 75 percent — of heroin users started out on prescription painkillers.
Those who abuse prescription opioids have a 40 times greater risk of abusing heroin, and the widespread misuse of prescription painkillers is thought to be at the heart of rising heroin addiction and related deaths.11
In fact, the CDC states that addiction to prescription opioid painkillers is the strongest risk factor for heroin addiction, and among heroin users, 45 percent are also addicted to opioid painkillers.12
It’s no coincidence, then, that the United Nations World Drug Report 2016 revealed a three-fold increase in U.S. heroin users from 2003, reaching about 1 million in 2014.
That’s the most reported in 20 years. Heroin-related deaths increased five-fold since 2000.13,14 In short, Americans’ excessive use of opioid painkillers has created a nation of drug addicts.
Changes in Opioid Prescription Pill Texture May Be Driving Rising Rates of Heroin Abuse
One step that was meant to help stop the epidemic may have inadvertently created a new one in the form of heroin use. Legislation led to a change in the texture of certain prescription opioids, which made them harder to crush and therefore to be injected into your bloodstream.
As a result, it’s thought that many former prescription opioid addicts turned to heroin instead.15 According to a report issued by the U.S. Drug Enforcement Administration (DEA) in April 2015:16
“Controlled prescription drug abusers who begin using heroin do so chiefly because of price differences, but also because of availability and the reformulation of OxyContin."
Deaths linked to a synthetic opioid called fentanyl are also on the rise. Fentanyl is 50 times stronger than heroin and was reportedly involved in the death of pop singer Prince earlier this year.
Fentanyl and heroin use can quickly turn deadly, but please don’t be misled that it takes heroin or fentanyl to cause a fatal overdose. All opioids depress your heart rate and breathing. Large doses can cause sedation and slowed breathing to the point that breathing stops altogether, resulting in death.
Stopping the drugs on your own, meanwhile, is difficult and typically causes significant withdrawal symptoms, including flu-like symptoms (nausea, vomiting, diarrhea, weakness and muscle cramps) that may last for up to 10 days.
Are You in Severe Pain?
If you’re in severe pain, there are times when these drugs have a place, and they can be of great benefit when used cautiously and correctly. It's quite clear however, that prescription opioid painkillers 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. So if you are dealing with severe or chronic pain, my first suggestion would be to see a pain specialist who is familiar with alternative treatments and the underlying causes of pain.
You need a knowledgeable practitioner who can help you attack the pain from multiple angles, giving you both relief and healing. One option that is receiving increasing attention in the U.S. is cannabis. It’s the cannabidiol (CBD) in cannabis that has medicinal properties. CBD is an excellent painkiller and has been used successfully to treat a variety of pain disorders.
In states where medicinal marijuana is legal, you can join a collective, which is a legal entity consisting of a group of people that can grow and share cannabis medicines with each other. By signing up as a member, you gain the right to grow and share your medicine.
I do, however, still recommend working with a health care practitioner who can guide you on the most effective dosage and form of use (cannabis may be inhaled, smoked, vaporized, taken orally or even applied topically in oil form).
Non-Drug Solutions for Pain Relief
Not everyone who takes a prescription opioid will wind up an addict, but the risk is real. This is why I strongly recommend exhausting other options before you resort to an opioid pain reliever. The health risks associated with these drugs are great and addiction and overdose happen far more often than you might think.
If you have chronic pain of any kind, please understand that there are many safe and effective alternatives to prescription and even over-the-counter painkillers. The pain remedies that follow are natural, providing excellent pain relief without any of the health hazards that pain medications often carry.
• Astaxanthin: one of the most effective oil-soluble antioxidants known, astaxanthin has very potent anti-inflammatory properties. Higher doses are typically required and one may need 8 milligrams or more per day to achieve this benefit.
• Ginger: this herb is anti-inflammatory 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: curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added only 200 milligrams of curcumin a day to their treatment plan had reduced pain and increased mobility. In fact, curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity, as well as demonstrating the ability in four studies to reduce Tylenol-associated adverse health effects.
• Boswellia: also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites, as I have seen it work well with many rheumatoid arthritis patients.
• Bromelain: this protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit.
• Cetyl Myristoleate (CMO): this oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used a topical preparation 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.
• Evening Primrose, Black Currant and Borage Oils: these contain the 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 transmit pain signals to your brain.
Dietary Changes and Additional Pain Relief Options
When physicians don’t know how to effectively treat chronic pain, they resort to the only treatment they know: prescription drugs, which will do nothing to solve the underlying reasons why you’re in pain. Toward that end, if you suffer from chronic pain, there’s a good chance you need to tweak your diet as follows:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief.
- Reduce your intake of most processed foods as not only do they contain sugar and additives, but also most are loaded with omega-6 fats that upset your delicate omega-3 to omega-6 ratio. This, in turn, will contribute to inflammation, a key factor in most pain.
- Eliminate or radically reduce most grains and sugars (especially fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain.
- 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. This satisfies your body’s appetite for regular sun exposure.
Finally, the natural pain relief methods that follow are useful for ongoing and lasting pain relief and management:
- Chiropractic adjustments: according to a study published in the Annals of Internal Medicine and funded by the National Institutes of Health (NIH), patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain-free in 12 weeks compared to those who took medication.17
- Massage: massage releases endorphins, which help induce relaxation, relieve pain and reduce levels of stress chemicals such as cortisol and noradrenaline.
- Acupuncture: researchers concluded that acupuncture has a definite effect in reducing chronic pain such as back pain and headaches — more so than standard pain treatment.18