Opioid Addiction Now Surpasses Smoking

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Story at-a-glance -

  • More Americans now use prescription opioids than smoke cigarettes. Substance abuse has also eclipsed cancer in terms of prevalence, and costs the U.S. more than the treatment of diabetes
  • Opiates such as oxycodone, hydrocodone, fentanyl and morphine are killing more Americans than car crashes, claiming the lives of more than 49,700 Americans in 2014
  • In 2015, 27 million Americans used illegal drugs and/or misused prescription drugs, and nearly one-quarter of all adolescents and adults reported binge drinking in the previous month

By Dr. Mercola

It's time to face the facts. America has a very serious drug addiction problem, and it stems from overprescription of painkillers. According to a recent report by the U.S. surgeon general, more Americans now use prescription opioids than smoke cigarettes.1

Substance abuse in general has also eclipsed cancer in terms of prevalence. Addiction to opioids and heroin is costing the U.S. more than $193 billion each year. Alcohol abuse is costing another $249 billion. In total, the cost of substance abuse far exceeds the cost of diabetes, which is also at a record high.

Opiates such as oxycodone, hydrocodone, fentanyl and morphine are also killing more Americans than car crashes.2 In 2014, more than 49,700 Americans died from opioid or heroin overdoses while 32,675 died in car accidents. According to the surgeon general's report, in 2015:

  • 27 million Americans took opioids
  • More than 66 million (nearly 25 percent of the total adolescent and adult population) reported binge drinking at some point in the previous month

Surgeon General Takes Aim at Drug Addiction

In 1964, the U.S. surgeon general's report on the health effects of smoking helped reshape the general attitude toward tobacco use. Surgeon general, Dr. Vivek Murthy, hopes his call to action on drug addiction and substance abuse will have a similar impact. As noted in a recent NPR interview with Murthy:3

"We now know from solid data that substance abuse disorders don't discriminate. They affect the rich and the poor, all socioeconomic groups and ethnic groups. They affect people in urban areas and rural ones. Far more people than we realize are affected …

For far too long people have thought about substance abuse disorders as a disease of choice, a character flaw or a moral failing. We underestimated how exposure to addictive substances can lead to full blown addiction.

Opioids are a good example. Now we understand that these disorders actually change the circuitry in your brain … That tells us that addiction is a chronic disease of the brain, and we need to treat it with the same urgency and compassion that we do with any other illness."

According to the report, every dollar invested in treatment saves $4 in healthcare costs and lost productivity, and another $7 in reduced criminal justice costs. Murthy's plan to address the addiction epidemic involves policy makers, regulators, scientists, families, schools and local communities.

This amounts to another American bailout, this time taxpayers will be footing the bill for a pharmaceutical induced epidemic - paying the same medical system that caused the problem for the antidote.

A Brief History on Heroin

Heroin was initially introduced by Bayer Co. in 1898. It was hailed as a "wonder drug," commonly used to treat pain and cough. Addiction rates grew once it was discovered that its effects were amplified when injected. As reported by CNN in an article covering the history of opioids:4

"In 1914, the Harrison Narcotics Tax Act imposed a tax on those making, importing or selling any derivative of opium or coca leaves. By the 1920s, doctors were aware of the highly addictive nature of opioids and tried to avoid treating patients with them.

Heroin became illegal in 1924 … By the mid- and late-1970s, when Percocet and Vicodin came on the market, doctors had long been taught to avoid prescribing highly addictive opioids to patients.

But an 11-line letter printed in the New England Journal of Medicine [NEJM] in January 1980 pushed back on the popular thought that using opioids to treat chronic pain was risky.

In it, Jane Porter and Dr. Hershel Jick mentioned their analysis of 11,882 patients who were treated with narcotics. They wrote that 'the development of addiction is rare in medical patients with no history of addiction.'"

Prescription opioids had been increasingly prescribed to patients with terminal illnesses, but prescription patterns took a radical turn in the mid-1990s, when opioids became the focus of a campaign aimed at increasing prescriptions to non-terminal patients with pain.

The Birth of OxyContin

Purdue Pharma started selling OxyContin in 1996. Two years later, the company produced a promotion video that was distributed to 15,000 doctor's offices across the U.S. In the video, a doctor is featured saying:

"The rate of addiction among pain patients who are treated by doctors is less than 1 percent. They don't wear out; they go on working; they do not have serious medical side effects. So, these drugs, which I repeat, are our best, strongest pain medications, should be used much more than they are for patients in pain."

Doctors apparently took notice, because a year later, opioid prescriptions had skyrocketed by an astounding 11 million. As noted in the video above, for many years, medical students were taught that if a patient is in serious pain, opioid painkillers will not have an addictive effect.

Not only does this defy logic, but this notion has also been scientifically proven FALSE. These drugs are addictive whether you're in pain or not, and the claim that less than 1 percent of pain patients develop an addiction to them was based on misinterpretation of Jick's limited data.

As one doctor admits, the campaign was aimed at destigmatizing the use of opioids, and in so doing, they often "left evidence behind." Pain has such an adverse impact on quality of life, doctors owed it to their patients to be more aggressive in the treatment of pain, the rationale went. As a result of this biased "education campaign," prescriptions for narcotic pain relievers rose by 600 percent in one decade, laying the groundwork for today's drug addiction epidemic.

Many Drug Addicts Got Their Start After a Minor Injury

As described in the BBC News video at the top of this article, many of today's addicts became hooked after receiving a prescription for an opioid following a relatively minor injury. Their injury healed, but the subsequent addiction is now ruining their lives, and the lives of their families.

Many, including young people, have also died as a result. As noted by Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC): "We know of no other medication routinely used for a nonfatal condition that kills patients so frequently."5 According to Frieden, studies show that addiction affects about 26 percent of those using opioids for chronic non-cancer pain. Worse, 1 in 550 patients on opioid therapy die from opioid-related causes within 2.5 years of their first prescription!

In addition to that, most studies investigating long-term use of opioids have lasted a mere six weeks or less, and those that lasted longer have, by and large, found "consistently poor results." Several of them found that opioid use worsened pain over time and led to decreased functioning — an effect thought to be related to increased pain perception.

How Revolving Door Policy Allowed Drug Addiction to Spiral Out of Control

I've written about the dangers of the revolving door policy that allows regulators to be hired by industry and vice versa on numerous occasions. In this case, former Drug ­Enforcement Administration (DEA) and Department of Justice (DOJ) officials hired by the drug industry fought for lenience and a "soft approach" to the burgeoning drug addiction problem.

They succeeded, thereby allowing the problem to grow more or less unrestrained, despite official promises to the contrary. As revealed in a Washington Post exposé:6

"A decade ago, the [DEA] launched an aggressive campaign to curb a rising opioid epidemic … The DEA began to target wholesale companies that distributed hundreds of millions of highly addictive pills to the corrupt pharmacies and pill mills that illegally sold the drugs for street use.

Leading the campaign was the agency's Office of Diversion Control, whose investigators around the country began filing civil cases against the distributors, issuing orders to immediately suspend the flow of drugs and generating large fines.

But the industry fought back. Former DEA and Justice Department officials hired by drug companies began pressing for a softer approach. In early 2012, the deputy attorney general summoned the DEA's diversion chief to an unusual meeting over a case against two major drug companies. 'That meeting was to chastise me for going after industry, and that's all that meeting was about,' recalled Joseph T. Rannazzisi, who ran the diversion office …

[O]fficials at DEA headquarters began delaying and blocking enforcement actions, and the number of cases plummeted … The judge who reviews the DEA diversion office's civil caseload noted the plunge. 'There can be little doubt that the level of administrative Diversion enforcement remains stunningly low for a national program,' Chief Administrative Law Judge John J. Mulrooney II wrote in a June 2014 quarterly report …"

Even DEA Officials Suspected Foul Play

In 2013, DEA lawyers also began insisting on increasingly higher standards of proof before moving cases forward. This included proof of intent — a factor that is very difficult to prove and typically only required in criminal cases. In 2011, 131 cases were filed against distributors, manufacturers, pharmacies and doctors involved in the illegal distribution of opioids. In 2014, that number dropped to 40.

In that same time frame, the number of "immediate suspension orders" dropped from 65 to nine. The suspension order allows the agency to freeze shipments of narcotics, effective immediately. Many DEA officials began suspecting Clifford Lee Reeves II, the lawyer in charge of approving their cases, of secretly working for the drug industry.

"We all had a feeling that someone put him there to purposely stonewall these cases," Frank Younker, a former DEA supervisor in the Cincinnati field office told The Washington Post. Younker retired two years ago after three decades with the DEA. Kathy Chaney, a DEA group supervisor in Columbus, Ohio said:

"We got so frustrated, I finally told my group, 'We're not going to send any cases up to headquarters.' In 25 years, I had never seen anything like it. It was one of the reasons I left. Morale was terrible. I couldn't get anything done. It was almost like being invisible … We were all very dedicated, and we were all deeply disappointed that the program was being manipulated this way."

Chaney's own mother died from an accidental Percocet overdose in 1979. She became addicted after receiving the drug following a car accident. Her mother's death was one of the reasons Chaney joined the DEA in the first place.

As these comments reveal, there are many good, solid workers out there, fighting to protect public health, yet corporations have been allowed to infiltrate key positions and manipulate from the top down, preventing any real progress that might harm the industry's bottom line. This is exactly why it's so important to combat this transfer of officials between government agencies and the industries they're supposed to investigate and police.

19 Non-Drug Solutions for Pain Relief

In October, comedian John Oliver took aim at the burgeoning drug epidemic,7 noting the roots of the problem: narcotic pain killers, and more importantly, drug companies that falsely claimed they were non-addictive and safe to use for virtually all kinds of pain. Well, the jig is now up, and such claims can no longer be made. It's extremely important to be fully aware of the addictive potential of opioid drugs, and to seriously weigh your need for them.

There are many other ways to address pain. Below are 19 suggestions. Clearly, there are times when pain is so severe that a narcotic pain reliever may be warranted. But even in those instances, the options that follow may allow you to at least reduce the amount you take, or the frequency at which you need to take them. If you are in pain that is bearable, please try these options first, before resorting to 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 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, by manipulating prostaglandins.)

Optimize your production of vitamin D

Optimize your vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.

Medical cannabis

Medical marijuana has a long history as a natural analgesic. Its medicinal qualities are due to high amounts (up to 20 percent) of cannabidiol (CBD), medicinal terpenes and flavonoids.

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. Medical marijuana is now legal in 28 states. You can learn more about the laws in your state on medicalmarijuana.procon.org.8

Emotional Freedom Techniques (EFT)

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, and 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.

Among volunteers who had never meditated before, those who attended four 20-minute classes to learn a meditation technique called focused attention (a form of mindfulness meditation), experienced significant pain relief — a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness.9

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.

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

Research has discovered a "clear and robust" effect of acupuncture in the treatment of back, neck and shoulder pain, osteoarthritis and headaches.

Physical therapy

Physical therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.

Massage

A systematic review and meta-analysis published in the journal Pain Medicine included 60 high-quality and seven low-quality studies that looked into the use of massage for various types of pain, including muscle and bone pain, headaches, deep internal pain, fibromyalgia pain and spinal cord pain.10

The review revealed that massage therapy relieves pain better than getting no treatment at all. When compared to other pain treatments like acupuncture and physical therapy, massage therapy still proved beneficial and had few side effects. In addition to relieving pain, massage therapy also improved anxiety and health-related quality of life.

Astaxanthin

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 milligrams (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 milligrams (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.11

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 mildly 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.

Methods such as yoga, Foundation Training, acupuncture, exercise, meditation, hot and cold packs and mind-body techniques can also result in astonishing pain relief without any drugs.

Grounding

Walking barefoot on the earth may also provide a certain measure of pain relief by combating inflammation.

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