By Dr. Mercola
According to a recent report by the U.S. Surgeon General, more Americans now use prescription opioids than smoke cigarettes.1 These drugs also kill more Americans than car crashes.2
Over the past five years, drug overdose deaths have risen by 33 percent.3 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."4
In 2015, 27 million Americans used illegal drugs and/or misused prescription drugs, and addiction to opioids and heroin now costs the U.S. more than $193 billion each year.
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.
According to the latest data from the National Center for Health Statistics (NCHS), life expectancy for both men and women dropped between 2014 and 2015, for the first time in two decades, and overdose deaths appear to be part of the problem.5,6,7
In all, more than 50,000 Americans died from drug overdoses in 2015, a rise of 11 percent from 2014.
Fortunately, there are safe options to treat pain. But education is sorely lacking. This is why I frequently write about this issue, and hope you'll do your part in spreading the word.
Far too many people in the prime of their life are losing it to painkiller addiction, and often they simply had no idea a prescription painkiller for a temporary injury or pain would send them into the throes of drug addiction.
Opioid Withdrawal — 'Hell on Earth'
In the featured video, created by STAT News, a former opioid addict named Matt Ganem explains the process of withdrawal from opiates such as oxycodone, hydrocodone, fentanyl and morphine.
"It's physical torture; it's mental torture," Ganem says. "You're literally coming undone at the seams; you're crawling out of your skin."
The drug works by attaching itself to opioid receptors in your brain, thereby blocking pain signals. This also has the effect of creating a sensation of pleasure or euphoria — and addiction.
Over time they can also 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 affect bodily functions such as respiration and heart rate, either slowing them down or speeding them up.8 Blood pressure is often acutely reduced, which raises your risk of a stroke.9
As explained in the video, over time, your body gets used to functioning at a slower rate. When you cease the drug, your hippocampus — the part of your brain that regulates emotions — gets overactive, causing anxiety, panic and erratic thoughts.
Your hypothalamus — which regulates body temperature — also starts malfunctioning, causing extreme sweating. Vomiting and/or diarrhea are also common side effects during the withdrawal phase.
And, as your previously blocked pain receptors begin to reactivate in the absence of the drug, severe agonizing pain sets in. Seizures can also occur.
Who Gets Hooked on Opioids?
The answer to that question is that it can happen to anyone. It doesn't matter where you live or how great a family you came from. NPR10 recently ran a story about Charlie Oen, whose addiction began at the age of 16.
He's now been clean for five years, and has been working as a recovery coach for the past two. He's one of the lucky ones.
STAT News' special report, "52 Weeks, 52 Faces" features obituaries of people who lost their lives to opioid addiction. You'd be hard-pressed to "peg" any one of them as a drug user.
"The faces above and the stories below are a snapshot of the devastating opioid epidemic sweeping across the United States," STAT News writes.
"Publicly acknowledging that a family member suffered from an addiction to drugs, or died of an overdose, has long been a taboo subject — one best kept secret among family and a few knowing friends. That is changing.
As the death toll from the opioid crisis mounts, families are increasingly weaving desperate warnings into the obituaries of loved ones about the horror that can result when people abuse painkillers, heroin and synthetic drugs such as fentanyl …
The victims were found in the woods, in a low-budget hotel, a dorm room and at home. On the same day in June, two brothers fatally overdosed. In November, a mother lost a third son to an opioid overdose.
Those who succumbed to opioids were also full of hope and promise. They served their country in the armed forces. They were college students, aspiring musicians, athletes, chefs, a race car driver, a high school student, an auto mechanic, a bank employee and the son of a former U.S. congressman."
Shifting Demographic of Drug Users Have Changed Views on Addiction
Today's drug users look like you and me. They look like your best friend, your mother or grandfather. They include teens and seniors;11 the wealthy and the poor. A recent article in The Washington Post highlighted the dramatic rise of drug addiction in rural America.12
During a single fateful day in the little city of Chillicothe, Ohio, seven children were taken into government custody after their parents overdosed on these drugs; one of the parents died. The local coroner likened the state of affairs to a "zombie apocalypse."
Addiction also frequently affects several generations of the same family, from kids to grandparents. In fact, drug addiction among seniors is more common than ever before. According to one recent study,13 15 percent of seniors on Medicare are prescribed an opioid upon discharge following an acute hospitalization and 42 percent of them are still taking the drug three months later, suggesting addiction may be an issue.
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 less affected by this epidemic, with 3.3, 2.2 and 0.7 per 100,000 dying from painkillers respectively. This shifting demographic of users has led to a change in how people view drug addiction.
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. In 2015, 67 percent of Americans said they support treatment over incarceration for drug addicts, and the 2017 federal budget includes $14.3 billion for treatment, compared to $9.5 billion for drug law enforcement.
The New Gateway Drugs
Oxycontin and other opioid painkillers have been identified as the primary gateway drugs to heroin,14 and the transition from prescription opioids to street heroin is an easy one. It's a story addicts tell again and again. Physical addiction to opioids 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.15
On average, the city records between 20 and 25 overdoses each week. This unprecedented number of overdoses was precipitated by heroin cut with carfentanil.16 Meant to deliver a stronger and more extended high, it resulted in greater overdoses and deaths.17 Considering the fact that carfentanil was originally developed as a tranquilizer for large animals such as elephants, an increased risk of death is to be expected.
Fentanyl Crisis Is Growing
Heroin topped the list of deadliest drugs in the U.S. in 2014,18 but fentanyl19 is quickly catching up, with overdose deaths doubling between 2013 and 2014.20 A December 28, 2016 article in The New York Times reports fentanyl now outpaces heroin as the deadliest drug on Long Island, New York.21,22
Fatalities from fentanyl overdoses have also surpassed heroin in other states. In New York City, nearly half of all unintentional drug overdose deaths between July and December 2016, involved fentanyl.
Nationwide, overdoses involving fentanyl rose by more than 72 percent between 2014 and 2015. Fentanyl is a synthetic opioid that can be anywhere from 500 to 1,000 percent more potent than morphine. Besides a more potent high, price is another factor driving its popularity. Since it can be created in a lab, it's far cheaper than heroin. According to Suffolk County medical examiner Dr. Michael J. Caplan:
"The influx of illicitly manufactured fentanyl from overseas is a nationwide issue that requires a multidisciplinary intervention from all levels of government."
Jeffrey Sheridan, an addiction counselor, told The New York Times: "We've never seen as much of a drug this strong on the black market before … It's not something you can use for any kind of duration and survive." Fentanyl was determined to be the drug responsible for the untimely death of Prince last April.23
To address this rapidly growing trend, senators Edward Markey (D-Mass) and Marco Rubio (R-Fla) have introduced a bipartisan bill to "elevate illicit fentanyl trafficking as a foreign policy priority."24 According to Markey:
"Fentanyl is trending as the deadliest illicit opioid drug our country is facing. Left unchecked, fentanyl threatens to cause a nationwide public-health crisis of epic proportions. Massachusetts is near the top of the list of states suffering fentanyl overdose deaths, but much of the rest of the country doesn't appreciate the threat that fentanyl is posing to the American people.
We must educate the public about the existence of illicit fentanyl and the harm it can do. We need to make sure that China and Mexico are living up to their promises to combat the flow of this deadly drug and other synthetic opioids into the United States. And we must develop a national strategy that includes collaboration with our international partners to help stop fentanyl's deadly impact."
Drug-Induced Brain Changes May Affect You for Life
Opioid use and addiction can have lifelong ramifications. According to Dr. Scott Krakower, assistant unit chief for psychiatry at Zucker Hillside Hospital in New York, opioids cause changes in your brain that can increase your risk of depression, and the effects may be "long-lasting or even permanent."25 Opiates depress your central nervous system and slow the electrical activity in your brain, which can result in circadian rhythm disruptions, mood changes and cognitive decline. Opiate use also promotes:26
- Bowel dysfunction (severe constipation is common, which could lead to intestinal rupture)
- Endocrine system (hormonal) problems
- Sexual dysfunction and/or reduced fertility
- Reduced testosterone levels in men
- Bone disorders
Pain and Hopelessness Fuel Opioid Crisis
According to recent research, half of all Americans are living with chronic illness,27 and many addiction specialists believe pain and hopelessness are driving the opioid crisis in the U.S. As noted in The Washington Post:28
"Fatal overdoses from prescription opioids have quadrupled since 1999 and heroin overdoses have gone up about six-fold since 2001. But other drugs also play a role. A Post analysis of federal health data found that white women are five times as likely as white men, for example, to be prescribed drugs for anxiety in tandem with painkillers, a potentially deadly combination.
Meanwhile, the suicide rate among middle-aged white women has risen in parallel with prescriptions for often-ineffective psychiatric drugs. Both have roughly doubled since 1999 … According to federal health officials, nearly 1 in 4 white women ages 50 to 64 are being treated with antidepressants. Binge drinking is also on the rise, as women close the gap with heavier-drinking white males."
Limiting the availability of opioids and making overdose-reversal drugs (naloxone) and treatment for drug addiction more readily available are certainly part of the answer. But it's not enough. We have to take a much deeper look at the root of the problem. What is causing all this physical and emotional pain in the first place?
Clearly, the U.S. health care system has gone wildly astray. It's blatantly ineffective at treating chronic health problems. Whether ill health is promoting hopelessness or the other way around is difficult to ascertain, but the two appear to be closely intertwined and need to be addressed together.
Somehow or another, we need to refocus our efforts to create lives worth living, and improve access to and information about basic disease prevention, such as healthy foods and foundational health-promoting lifestyle strategies.
West Virginia County Sues Painkiller Distributors
We also need to hold pharmaceutical companies accountable for their role in creating this (and other) health crises. The drug addiction epidemic is snowballing, yet drug companies still are not doing much to prevent people from dying from their drugs. Instead, some actually appear to be promoting and supporting drug addiction on purpose.
The McDowell County Commission of West Virginia recently filed a lawsuit against three national painkiller distributors (McKesson Corp., Cardinal Health Inc. and AmerisourceBergen Drug Co.) and one physician, accusing them of creating an epidemic of addiction in the county.29 Between 2007 and 2012, these three drug distributors sent 423 million hydrocodone and oxycodone pills to West Virginia pharmacies and doctors' offices.
More than 12 million pills were shipped to McDowell County in that time. McDowell County has a population of 28,000 — and the highest rate of overdose deaths per capita in the United States. Nearly 9 million hydrocodone pills were sent to a pharmacy in Mingo County over the course of two years.30 Mingo County has a total population of 33,000, but a mere 400 residents live in the town where the pharmacy is located.
Still, this single pharmacy was distributing enough pills to give each and every county resident 136 pills per year! Federal and state laws require drug wholesalers to report suspicious orders and halt shipments. The distributors being sued didn't, even though warning bells should have been ringing loud and clear.
Dozens of DEA Officials Hired by Opioid Makers
What's more, STAT News recently reported that, just as the U.S. Drug Enforcement Agency (DEA) began cracking down on distributors shipping pills to known "pill mills" — pain management clinics prescribing so many painkillers it's highly likely they're supplying drugs to addicts — opioid makers hired no less than 42 DEA officials into their corporate ranks.31
At least 31 of them came from the division regulating painkillers. This is yet another clear sign that drug companies are trying everything they can to keep this fabulously lucrative business going — even though it devastates families, destroys lives and kills tens of thousands each year.
Even more infuriating, when drug makers or their distributors are found guilty of malfeasance, the punishment is usually so negligible it makes no difference whatsoever. For example, Kinnray LLC., a drug distributor owned by Cardinal Health Inc., recently agreed to pay $10 million to resolve claims it failed to report suspicious pill mill activity to the DEA.32 That's basically a slap on the wrist when you consider the vast sums made from these pills.
These companies KNOW their actions will result in addiction and death. Yet they do it anyway, and get off scot-free with nothing but a minor fine. Their actions may not entirely meet the legal definition of manslaughter or murder, but the end result is certainly identical. They are killing people and they know it. In my view, many of them should be in jail, rubbing shoulders with all the other drug dealers.
Non-Drug Solutions for Pain Relief
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.33
Kratom (Mitragyna speciose) is another plant remedy that has become a popular opioid substitute.34 In August, the 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.35
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.36
✓ 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.
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 health care 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
Physical therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
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 and spinal cord pain.37
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 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.
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.38
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 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.
Walking barefoot on the earth may also provide a certain measure of pain relief by combating inflammation.