Prescription for Change — How to End America's Opioid Addiction

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Story at-a-glance -

  • More Americans now use prescription opioids than smoke cigarettes. Opiates such as oxycodone, hydrocodone, fentanyl and morphine also kill more Americans than car crashes each year
  • In 2015, 27 million Americans used illegal drugs like heroin and/or misused prescription drugs. Addiction to opioids and heroin is costing the U.S. more than $193 billion each year
  • Native Americans and Caucasians have the highest rate of death from opioids; 8.4 and 7.9 per 100,000 people respectively. African Americans and Latinos have a death rate of 3.3 and 2.2 per 100,000

By Dr. Mercola

The MTV production "Prescription for Change" highlights the struggles of drug addiction and includes interviews with President Obama, in which he urges users to seek help, and discusses the need for more and better treatment programs, regardless of the user's ability to pay.

The video also discusses the history of opioids that led to the current addiction epidemic. Purdue Pharma, the manufacturer of OxyContin, lied to doctors and patients, convincing them that OxyContin — a narcotic pain killer — was safe and non-addictive when prescribed for pain.

Starting in 1996, Purdue unleashed more than 20,000 "educational programs" to encourage long-term use of opioids to control non-cancer pain,1 even though there were no studies to support the use of opioids long-term in patients with non-fatal conditions.2 

In the first year (1996) sales of Oxycontin reached $45 million. By 2000, that number had ballooned to $1.1 billion.3 Ten years later sales had tripled to $3.1 billion, gobbling up 30 percent of the market.4

Addiction Epidemic Was No Fluke

Misinformation and manipulation of scientific facts by drug makers have led to a drug crisis of truly astounding proportions, with more Americans now using prescription opioids than those who smoke cigarettes.5

In Alabama, which has the highest opioid prescription rate in the U.S., there are 143 prescriptions for every 100 people.6 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.7 In fact, many of today's addicts became hooked after being prescribed a narcotic pain reliever following dental surgery or a relatively minor injury.

Heroin use more than doubled in 18- to 25-year-olds between 2002 and 2011,8 and this rise in heroin addiction was a direct result of prescription opioid addiction among young patients.

Crazy enough, just last year — in the midst of rallying cries to get a better handle on the burgeoning crisis — the U.S. Food and Drug Administration (FDA) approved the use of opioids in children as young as 11.9 I shudder to imagine what this might do to an entire generation of children!

Opioids Top the List of Potentially Lethal Drugs

In 2015, 27 million Americans used illegal drugs like heroin and/or misused prescription pain killers. Oxycontin and other opioid pain killers have been identified as the primary gateway drugs to heroin10 — something every person out there needs to be fully aware of.

According to a study published in JAMA Internal Medicine,11 while most opioid drug abusers obtain the drug from a friend or relative, (23 percent pay for them; 26 percent get them for free), individuals who are at greatest risk for drug abuse are just as likely to get them from their doctor.  

Addiction to opioids and heroin is now costing the U.S. more than $193 billion each year. Opiates such as oxycodone, hydrocodone, fentanyl and morphine
also kill more Americans than car crashes each year.12

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."13

He has also warned that "Patients given just a single course may become addicted for life."14 Doctors and patients simply must become fully cognizant of this immense risk.

Studies Do Not Support Use of Opioids for Long-Term Use

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 dies from opioid-related causes within 2.5 years of their first prescription.

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.

3 Factors That Make You More Prone to Opioid Addiction

Opioid painkillers work by interacting with receptors in your brain resulting in a decrease in the perception of pain — at least temporarily. As mentioned, over time they can result in increased pain perception, setting into motion a cycle where you need increasingly larger doses, making a lethal overdose more likely.

Oxycontin's high rate of addiction is the result of a short half-life (the amount of time the drug stays in your system before you are left wanting more). Opioids also create a temporary feeling of euphoria, followed by dysphoria, that can easily lead to physical dependence and addiction.

However, why certain people become addicted while others don't has remained a mystery. Researchers from the University of Derby set out to determine what might be influencing painkiller addiction by conducting an anonymous survey of people who had pain and had used painkillers in the last month.

The three predictors that identified those most at risk of developing painkiller dependence included those who:15

  1. Used prescription painkillers more frequently
  2. Have a prior history of substance abuse (often unrelated to pain relief)
  3. Are less accepting of pain or less able to cope with pain

According to the authors "Based on these findings, a preliminary model is presented with three types of influence on the development of painkiller dependence: 1) pain leading to painkiller use, 2) risk factors for substance-related problems irrespective of pain and 3) psychological factors related to pain."

From Prescriptions to Street Drugs

The transition from prescription opioids to street heroin is an easy one. Physical addiction to the drug drives behavior to seek more of the same drug.

When a prescription runs out, a physician refuses to renew, or the cost of the prescription becomes too high to manage, many addicts turn to heroin. Chemically, these drugs are very similar and they provide a similar kind of high.

Without additives, street heroin is as dangerous as Oxycontin, and just as addictive. However, when dealers cut the drug with other drugs, the result may be deadly. In just six days in August 2016, 174 overdoses of heroin were recorded in Cincinnati, Ohio, the largest number of overdoses in one week on record.16

On average, the city records between 20 and 25 overdoses each week. This unprecedented number of overdoses was precipitated by heroin cut with carfentanil.17 Meant to deliver a stronger and more extended high, it resulted in greater overdoses and deaths. This is to be expected, when you consider the drug was originally developed as a tranquilizer for large animals, such as elephants.

Carfentanil is the strongest commercially prepared opioid. Dealers find it delivers a stronger and more addictive high. Newtown Police Chief Tom Synan told Channel 9 WCPO:18

"These people are intentionally putting in drugs they know can kill someone. The benefit for them is if the user survives it is such a powerful high for them, they tend to come back … If one or two people die, they could care less. They know the supply is so big right now that if you lose some customers, in their eyes there's always more in line."

Drug Addiction — a Crime or a Disease?

As noted in the video, drug addiction has long been treated as a crime. Views are now changing, and in his recent report on substance abuse, U.S. surgeon general Dr. Vivek Murthy stresses the importance of recognizing drug addiction as a disease.19 He recently told NPR:20

"We now know from solid data that substance abuse disorders … affect the rich and the poor, all socioeconomic groups and ethnic groups. They affect people in urban areas and rural ones … 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."

While this is good news for addicts and their families, this change did not occur until the victims of addiction were primarily Caucasian. Prior to the opioid epidemic, most people were convinced heroin was a problem relegated primarily to communities of color, and heroin users were viewed as a criminal element.

In 2001, 45 percent of Americans supported tough drug laws where users were simply sent to jail, and most of the federal spending relating to drug abuse was spent on law enforcement. Today, Native Americans and Caucasians have the highest rate of death from opioids; 8.4 and 7.9 per 100,000 people respectively. African Americans, Latinos and Asians are far less affected by this epidemic, with 3.3, 2.2 and 0.7 per 100,000 dying from pain killers respectively.

This shifting demographic of users has led to a change in how people view drug addiction. In 2015, 67 percent of Americans said they support treatment over incarceration for drug addicts, and the 2017 federal budget now includes $14.3 billion for treatment, compared to $9.5 billion for drug law enforcement.

Ending the Epidemic

At present, only 1 in 10 drug addicts receive the help they need, and those who do get into treatment typically face long wait times. About one-third of those who need treatment cannot afford it, or don't have insurance coverage. There's still an enormous amount of work that needs to be done to turn this epidemic around, but part of the answer is to become an educated patient, and to never fill that opioid prescription in the first place.

The drug industry and prescribing doctors must also acknowledge their role and take responsibility for its resolution. As noted in the video:

"We need big pharma to be honest about the products they're selling us. We need doctors to prescribe opiates only when they're absolutely necessary. We need to think of addiction as a treatable medical condition so people can openly ask for help, like they would for any illness.

We need to improve treatment, so it's scientific and long-term. We need to shift money away from incarceration and into expanding treatment, so everyone has access as soon as they need it. If you or a friend are struggling with drugs or alcohol, visit halfofus.com for ways to get help."

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.21

Kratom

Kratom (Mitragyna speciose) is another plant remedy that has become a popular opioid substitute.22 In August, the U.S. Drug Enforcement Administration (DEA) issued a notice saying it was planning to ban kratom, listing it as Schedule 1 controlled substance.

However, following massive outrage from kratom users who say opioids are their only alternative, the agency reversed its decision.23

Kratom is likely safer than an opioid for someone in serious and chronic pain. However, it’s important to recognize that it is a psychoactive substance and should not be used carelessly. There’s very little research showing how to use it safely and effectively, and it may have a very different effect from one person to the next.

Also, while it may be useful for weaning people off opioids, kratom is in itself addictive. So, while it appears to be a far safer alternative to opioids, it’s still a powerful and potentially addictive substance. So please, do your own research before trying it.

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.24

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.25

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.26

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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