By Dr. Mercola
Increasing numbers of middle-aged Americans are becoming hooked on painkillers, often after using the drugs for back pain. Seeking ever-stronger highs, more potent drugs are now reaching the black market.
There’s W-18, a synthetic opioid that’s said to be 100 times more potent than the opioid pain reliever fentanyl and 10,000 times stronger than morphine. Fentanyl is also being picked up by drug traffickers, who are selling it mixed with (or instead of) heroin.
It’s cheaper to make and far more potent than heroin, making it extremely easy to overdose. In New Orleans, deaths caused by Fentanyl are now higher than the murder rate.1
Meanwhile, 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.2,3 The United Nations World Drug Report 2016 also 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.
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.4
Clearly, Americans’ excessive use of opioid painkillers has created a nation of drug addicts, which leaves the burning question: how did this excessive opioid use begin?
Sealed Opioid Report May Hold Clues to the Opioid Overdose Epidemic
In 2012, as opioid overdoses continued to rise, two senators — Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) — began an investigation into financial ties between the drugs’ makers and the medical organizations setting guidelines on opioid use.
The targets of the investigation were Purdue Pharma (maker of Oxycontin), Endo International plc (Percocet) and Johnson & Johnson (Duragesic) along with five organizations, including the Center for Practical Bioethics and the American Pain Foundation (APF).
Senate staffers spent a year working on the investigation and subsequent report, but its results have not been made public (the report is sealed in the Senate Committee on Finance's office).5
Financial Ties Between Drug Makers, Nonprofits and Policy Makers
There are many reasons to question the relationships between opioid makers and some leading non-profits, as well as their influence on the now out-of-control opioid epidemic. STAT reported some of the most concerning examples in an op-ed article:6
- The APF, billed as the largest U.S. organization for pain patients, was at one point receiving 90 percent of its funding from pharmaceutical and medical device companies (the foundation shut down days after the investigation began)
- The Center for Practical Bioethics, which is a supposedly independent nonprofit that helps policymakers and corporate leaders make health care decisions, received ample funding from Purdue Pharma, including seed money to create a $1.5-million chair in pain management
Myra Christopher, who co-founded the Center for Practical Bioethics and holds the chair in pain management, has authored studies in support of opioid use. STAT reported:7
“In 2008, Christopher coauthored a study to calm physicians’ fears that they might be criminally prosecuted or disciplined for inappropriately prescribing opioids.8
In 2011, as money from pharmaceutical companies continued to pour into the center, she wrote a commentary titled ‘It’s Time for Bioethics to See Chronic Pain as an Ethical Issue’ for the American Journal of Bioethics,9 which was then housed at the Center for Practical Bioethics.
The commentary failed to disclose that the center had received funding from the pharmaceutical industry and was one of many articles promoting opioid use the journal published.”
Due to changes in position, it’s now Senator Orrin Hatch (R-Utah), current chair of the Senate Committee on Finance, and Senator Ron Wyden (D-Ore.), who stand to get the opioid report released.
In 2015, public health advocates asked the senators that the findings of the opioid prescribing investigation be released, noting that many of those targeted by the report continue to “promote aggressive opioid use and continue to block federal and state interventions that could reduce overprescribing.”10 Still, the report remains sealed.
New Haven, Connecticut, Declares Public Health Emergency Due to Overdoses
In late June, New Haven, Connecticut — a city known for its New England charm and Yale University — declared a public health emergency after 16 people overdosed on tainted heroin or cocaine in a one-week period.11
Police were investigating whether fentanyl was involved. The surge in overdoses highlights the fact that drug overdoses have reached virtually the entire U.S. In Connecticut alone, more than 200 people had already died from accidental drug overdoses.
Unfortunately, stats like these are not unique. In Utah, 24 people die each month from prescription drug overdoses, and such deaths have outpaced deaths due to firearms, falls and motor vehicle crashes. In Utah, the majority of prescription drug overdoses are due to oxycodone.12
Connecticut Senator Richard Blumenthal told The New York Times, “an increase in ‘treatment services, law enforcement support, opioid overprescription prevention and other steps’ was ‘urgent and critical,’” and this sentiment applies not only to his home state but all of the U.S.13
Overdose Deaths Are Overwhelming Coroner Offices
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 U.S. 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 the NAME, again highlighted the fact that this problem isn’t confined to one area; it stretches across the U.S. He told STAT:14
“There are many, many parts of the country that have substantial problems … I think the drug overdoses have substantially increased the problems.”
Painkiller Deaths Drop in Medical Marijuana States
If you’re in severe pain, there are times when opioid 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.
If you’re in severe 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 medical marijuana.
It’s the cannabidiol (CBD) in marijuana that has medicinal properties. CBD is an excellent painkiller and has been used successfully to treat a variety of pain disorders.
In states where medical marijuana is legal, overdose deaths from opioids like morphine, oxycodone and heroin decreased by an average of 20 percent after one year, 25 percent after two years and up to 33 percent by years five and six.15 For those with severe chronic pain, medical marijuana can be life changing, allowing for a far safer form of treatment than opioids.
There is a wealth of research linking marijuana with pain relief. In one study, just three puffs of marijuana a day for five days helped those with chronic nerve pain to relieve pain and sleep better.16 I do, however, still recommend working with a health care practitioner who can guide you on the most effective dosage and form of use (marijuana 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.
Many people find themselves addicted to painkillers before they even realize what’s happened, often after taking the drugs to recover from surgery or treat chronic back, or other pain. The drugs work by binding to receptors in your brain to decrease the perception of pain. But they also create a temporary feeling of euphoria, followed by dysphoria, which can easily lead to physical dependence and addiction.
This may drive some people to take larger doses in order to regain the euphoric effect or escape the unhappiness caused by withdrawal. Others find they need to continue taking the drugs not only to reduce withdrawal symptoms but also to simply feel normal. Large doses of the painkillers can cause sedation and slowed breathing to the point that your breathing stops altogether, resulting in death.
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