Depressed and Anxious Patients Receive More Than Half of All Opioid Prescriptions

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  • In 2014, 1.2 million Americans ended up in the emergency room with an opioid-related side effect; in 2015, 33,000 died from an opioid-associated drug overdose
  • Adults with depression and anxiety receive 51 percent of all opioid prescriptions in the U.S.; 19 percent of the 38.6 million Americans diagnosed with a mental health disorder use opioids, compared to 5 percent of the general population
  • Women are being prescribed opioids during pregnancy and after delivery, creating drug dependent mothers and infants; 23 percent of 1.1 million pregnant women enrolled in Medicaid filled a prescription for an opioid in 2007

By Dr. Mercola

According to Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention (CDC), opioids kill patients more frequently than any other medication used for nonfatal conditions.1 Back pain has been identified as one of the most common reasons for receiving a prescription for a narcotic pain reliever.2 Disturbingly, more than half of all opioid prescriptions in the U.S. are given to patients suffering from anxiety and other mental health disorders.

The reason why is unclear, although it's possible that depressed and anxious patients experience a greater degree of physical pain as well. Whatever the reason, when you consider the addictive potential of these drugs and the fragile mental state of people already struggling with mental health problems, the harm of this trend could be phenomenal indeed.

Data also reveals that women are increasingly being prescribed opioids during pregnancy and after delivery, creating addicts in the womb and destroying families by creating drug-dependent mothers and infants.

According to a recent survey,3 more than 1 in 5 Americans insured by Blue Cross and Blue Shield were prescribed an opioid in 2015. At that rate, you're virtually guaranteed to receive a prescription for a narcotic at some point, provided you're seeing a doctor. Your chances of developing a drug dependency is high as well. Insurance claims involving opioid dependence rose by nearly 500 percent between 2010 and 2016, Blue Cross and Blue Shield reports.

Over Half of Opioids Prescribed to Those With Mental Health Challenges

According to recent findings,4 doctors are far more likely to prescribe opioids to patients who are depressed or complain of anxiety than those who do not have any mental health issues. Depressed and anxious patients also receive higher dosages. Remarkably, nearly 19 percent of the 38.6 million Americans diagnosed with a mental health disorder use opioids.

For comparison, only 5 percent of the general population — people without a mental health disorder — use narcotic painkillers. As reported by Valley News:5

"Adults with depression and anxiety receive 51 percent of the … opioid prescriptions distributed each year in the U.S. … The higher rate of use of opioids among those with the two most common types of mental illness in the country holds true across all levels of pain and across different types of pain, including that stemming from cancer and arthritis …

'Independent of pain and independent of medical conditions, having a mental health disorder is strongly associated with getting an opioid prescription, which is really, really concerning,' Dr. Brian Sites, [an] anesthesiologist, said … The study did not determine what might be causing the increased rate of opioid prescriptions for those with mental health disorders, but it may indicate a problem in providers' prescription practices, Sites said.

'We know that the relationship between mental health issues and pain is very complicated because pain is a subjective phenomena [sic], (for which) there's no biological measure' … A person with anxiety or depression might be more likely to have a condition known as 'pain catastrophizing,' in which people dwell on or feel hopeless about their pain,' Sites said."

Why Do so Many Depressed Patients Receive Opioids?

As mentioned, the study was not designed to tease out the reasons why different patient categories were prescribed opioids at different rates. Pain catastrophizing may explain part of the trend. Other possible reasons include:

Doctors may be more likely to prescribe painkillers to depressed or anxious patients out of empathy

Payment structures tied to patient satisfaction scores may influence doctors to prescribe painkillers to depressed patients, as patients tend to be more satisfied when they receive something tangible (a pill, opposed to general lifestyle advice) from their doctor

Opioids may have a short-term antidepressant effect, making depressed patients more likely to continue using the drug once the physical pain has healed

As noted by Sites, to stem the tide of opioids prescriptions, doctors need "more ready access to alternatives to opioids such as cognitive behavioral therapy, acupuncture, acupressure, massage therapy, physical therapy and nonopioid pharmaceuticals that are effective."6

He also pointed out that since patients with mental health problems receive the bulk of the opioids, are prescribed higher doses than the general population, and are at increased risk of dependency and addiction, this is the patient population we need to focus on when devising policies to clamp down on out-of-control opioid prescriptions.7

Opioid Epidemic Keeps Escalating

According to preliminary data, drug overdoses (all kinds) killed between 59,000 and 65,000 Americans last year. Opioids, specifically, killed 33,000 in 2015.8,9,10 Opioids have also been identified as the primary gateway drug to heroin and synthetic opioids like fentanyl, both of which add to the drug overdose burden.

As noted by Vox Magazine,11 the Vietnam War, in its entirety, claimed the lives of 58,000 American troops. Essentially, we're suffering a death toll exceeding that of the Vietnam War each and every year now, courtesy of dangerous drugs, most of which are by prescription!

The U.S. Senate is now considering allotting $45 billion in health care grants for opioid addiction treatment over the next decade. But even though $4.5 billion per year sounds like an enormous amount of money, addiction specialists warn it's "drastically short" of what's actually needed.12,13

This is all taxpayers' monies, paying for a substance abuse epidemic created and meticulously fueled by drug companies using misinformation and straight-out lies. I recently wrote about this in "How Misuse of a Single Paragraph Killed 60,000 Americans Per Year."

EMFs Raise Your Risk of Depression and Anxiety

Like opioid addiction, depression and anxiety have skyrocketed in recent years, and it's important to realize how your lifestyle is contributing to the problem. Based on the evidence, I now believe exposure to electromagnetic fields (EMFs) and non-native microwave radiation plays an important role in depression and anxiety.

Conventional science and industry is clinging to the concept that microwave radiation from cellphones, portable phones, Wi-Fi routers, smart meters and wireless computers and tablets is harmless because they don't cause thermal damage. However, new research14 from Professor Emeritus Martin Pall has now provided us with the mechanism of how this low-level, nonthermal microwave exposure causes biological harm.

Pall discovered this mechanism while evaluating over two dozen studies showing you can radically reduce biological microwave damage using calcium channel blockers. Embedded in your cell membranes are voltage gated calcium channels (VGCCs). Once these VGCCs are activated by microwaves, about 1 million calcium ions per second are released, and these ions then stimulate the release of nitric oxide (NO), which combines with superoxide to form peroxynitrate.

These peroxynitrates then create hydroxyl free radicals, the most destructive free radicals known to man, which decimate mitochondrial and nuclear DNA, membranes and proteins that lead to mitochondrial dysfunction, which we now know is at the heart of most chronic disease.

Pall has calculated that these VGCCs are over 7 million times more sensitive to microwave radiation than the charged particles inside and outside the cell, which means the currently established safety standards for cellphones are off by a factor of over 7 million.

If You Struggle With Anxiety, Reduce Exposure to Wireless Electronics

This research explains why the argument that microwave radiation is not high enough to cause biological damage is fatally flawed. The radiation does not cause thermal damage, that's true, but it does cause massive biological damage by activating VGCCs in your cells and causing a cascade effect that results in hydroxyl free radicals being produced.

So, how does microwave radiation promote anxiety and depression specifically? Simple: The tissues with the highest density of VGCCs are your brain, your nerve tissue (like the pacemaker in your heart) and male testes. This helps explain why we have an exponential increase in not only anxiety and depression but also more serious neurological diseases such as autism and Alzheimer's, as well as arrhythmias and male infertility.

Failure to realize this and take steps to minimize exposure will not only damage your DNA and increase your risk of most chronic illness; it will also seriously impair your body's ability to remove toxins, and significantly impair your immune response to address the large variety of pathogenic infectious assaults.

The take-home message is this: If you or someone you love struggles with anxiety or depression, it would be wise to take whatever steps necessary to minimize your exposure to cellphones, portable phones, Wi-Fi routers, smart meters, wireless computers and tablets. You may also need to address other sources of dirty electricity in your home.

Pregnant Women — Another Vulnerable Target Group

Getting back to the issue of opioids, another startling discovery is the fact that women are being increasingly prescribed opioids during pregnancy and after delivery, thereby creating drug dependent mothers and infants. Of the 1.1 million pregnant women enrolled in Medicaid in 2007, nearly 23 percent filled a prescription for an opioid drug. That's 18.5 percent higher than in 2000.15

A majority of these opioids are prescribed for back and/or abdominal pain, which are exceedingly common complaints during pregnancy. As noted by Rishi J. Desai, a research fellow at Brigham and Women's Hospital, "One in 5 women using opioids during pregnancy is definitely surprising."16

Interestingly, prescription rates vary significantly between regions. In Utah, nearly 42 percent of pregnant women enrolled in Medicaid received opioids while only 9.5 percent of those in Oregon and New York received them. What this suggests is that areas with high rates of prescriptions may be overlooking potential misuse and abuse.

According to recent research, opioids taken during the first trimester double a child's risk of neural tube defects that damage the brain, spine and/or spinal cord. When a woman uses opioids during the latter half of her pregnancy, she also raises the child's risk of drug dependency in utero, leading to neonatal abstinence syndrome.

Please, take care to avoid becoming part of this devastating trend. Studies show 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.17

Pregnant Women Use a Disturbing Amount of Drugs

Opioids are also frequently prescribed following cesarean delivery, and 1.4 million C-sections are performed in the U.S. each year. Here too, researchers struggle to determine the most appropriate way to dispense pain medications. Recent investigations suggest most women receive far more pills than they actually need to control their post-surgical pain following a C-section.18

These excess pills may then be misused, either by the mother or someone else in the household. Overall, pregnant women are using more pharmaceuticals during pregnancy than ever before. In the past three decades, prescription drug use during the first trimester has increased by more than 60 percent, and use of four or more drugs during pregnancy has more than tripled.19

Anytime you take more than one medication at once, your chances of experiencing adverse effects increase exponentially, and recent findings suggest pharmacists miss half of all dangerous drug combinations. A whopping 63 percent of CVS pharmacies dispensed toxic drug combinations with no warning to patients, while Walgreens, which ranked the safest, had a 30 percent failure rate.20 You simply cannot depend on others safeguarding your health. The only 100 percent safe drug is the one you don't take.

Opioid Epidemic Exacts Greater Toll on Women Than Men

As it turns out, the opioid epidemic is taking a greater toll on women in general. In the last decade (2005 through 2014), opioid-related emergency room visits have nearly doubled, but while hospitalization rates among men rose by 55 percent, hospitalizations among female opioid users went up by 75 percent.21 In all, 1.2 million Americans ended up in the emergency room with an opioid-related side effect in 2014.

As noted by Anne Elixhauser, senior research scientist at the Agency for Healthcare Research and Quality (AHRQ), "The deaths are horrible and startling, but the [total] burden of opioids is phenomenal."22 Indeed, every time new data comes out, the situation looks dimmer than before. According to the latest statistics,23,24 opioid addiction rose by 493 percent between 2010 and 2016, now affecting 8.3 out of every 1,000 opioid users.

In that same time, medication-assisted treatment25 (the current standard of care for opioid dependency, which combines behavioral therapy with medications such as buprenorphine or methadone) went up by just 65 percent, suggesting a vast majority of opioid addicts are suffering in silence. According to the U.S. Surgeon General, only 1 in 10 people struggling with some form of substance abuse receive treatment; 40 percent never seek treatment at all.

Needless to say, the irony of the situation is that while drug companies are responsible for creating this epidemic of drug addiction, other drugs are being pushed as the answer, allowing drug companies to rake in the cash from both ends while taxpayers foot the bill. One of the latest drug addiction treatments in the pipeline is an anti-heroin vaccine.26 The vaccine, which has so far only been tested on primates, is said to block the high normally caused by heroin for up to eight months after inoculation.27

Opioids Are Potent Immune Suppressors

Opioids treat pain by attaching 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 result in increased pain perception, setting into motion a cycle where you need increasingly larger doses, making a lethal overdose more likely. But overdosing is not the only risk you face when using an opioid drug.

A little-known and often overlooked fact about opioids is that they are also very potent immune suppressors. As such they can destroy your health in more ways than one, leaving you far worse off than when you started. In fact, several studies show that one primary risk for HIV and AIDS is opiate exposure.28,29,30,31

In cancer patients, opiates have a tendency to produce a rapid decline in health, as the drug causes their immune system to falter. So please remember, opiates are highly immunosuppressive drugs that raise your risk of any number of diseases, as your immune system is your frontline defense against all disease.

State Lawsuit Results in Paltry Settlement

Despite the fact that Americans are dying at unprecedented rates from Big Pharma's prescription painkillers, the pharmaceutical industry is rarely named by the establishment media for its deadly role in the growing opioid epidemic. Granted, states and cities are suing drug companies for damages to help pay for the epidemic they created, but justice remains elusive.

A lawsuit filed by Kentucky against Purdue Pharma, which settled in December 2015, resulted in a paltry $24 million settlement. Now, Kentucky Senate President Robert Stivers is intervening in a legal effort to unseal documents related to the case — a move that could potentially jeopardize the already agreed upon settlement with the state.

The documents in question include "a deposition of Dr. Richard Sackler, a former president of Purdue and a member of the family that owns the company; internal emails about the marketing of the drug; minutes of strategy meetings; analysis by the company of clinical trials; and other documents," STAT News reports.32 These court records were sealed from public view, and Stivers is now calling on Kentucky's attorney general, Andy Beshear, to unseal the records. According to STAT News:

"Stivers … said the release of the documents is important to evaluate whether the $24 million payment from Purdue represented a good settlement for Kentucky. The state originally filed the case in 2007. Two prior attorneys general valued the case at between $100 million and $1 billion. Stivers said the state settled for 'pennies on the dollar.'"

Treating Your Pain Without Drugs

While opioid painkillers may relieve pain temporarily, the addiction risks can quickly send you spiraling out of control. Many families touched by opioid addiction end up suffering for years before finally losing a loved one to addiction. While every case is tragic, it is particularly disturbing when the victim is a new mother.

I cannot stress enough the importance to avoid opioids during pregnancy and after delivery. If you end up needing a C-section, carefully evaluate your need for them, and be sure to discard any leftover pills by returning them to your pharmacy. It's important to realize there are many natural alternatives to treating pain.

It's particularly important to avoid opioids when trying to address long-term chronic pain, as your body will create a tolerance to the drug. Over time, you may require greater doses at more frequent intervals to achieve the same pain relief. This is a recipe for disaster and could have lethal consequences. Following is information about nondrug remedies, dietary changes and bodywork interventions that can help you manage your pain.

Medical cannabis: Medical marijuana has a long history as a natural analgesic and is now legal in 28 states. You can learn more about the laws in your state on medicalmarijuana.procon.org.33

Kratom: Kratom (Mitragyna speciosa) is a plant remedy that has become a popular opioid substitute.34 In August 2016, the DEA issued a notice saying it was planning to ban kratom, listing it as a 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 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 be used carefully. 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. The other issue to address is that there are a number of different strains available with different effects.

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.

Low-Dose Naltrexone (LDN): Naltrexone is an opiate antagonist, originally developed in the early 1960s for the treatment of opioid addiction. When taken at very low doses, LDN, available only by prescription, triggers endorphin production, which can boost your immune function and ease pain.

Curcumin: A primary therapeutic compound identified in the spice turmeric, curcumin has been shown in more than 50 clinical studies to have potent anti-inflammatory activity. Curcumin is hard to absorb, so best results are achieved with preparations designed to improve absorption. It is very safe and you can take two to three every hour if you need to.

Astaxanthin: One of the most effective oil-soluble antioxidants known, astaxanthin has very potent anti-inflammatory properties. Higher doses are typically required for pain relief, and you may need 8 milligrams or more per day to achieve results.

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 it worked well for many of my former 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 most of the bromelain is found within the core of the pineapple, so consider eating some of the pulpy core when you consume the fruit.

Cayenne cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain.

Cetyl myristoleate (CMO): This oil, found in dairy butter and fish, acts as a joint lubricant and anti-inflammatory. I have used a topical preparation of CMO to relieve ganglion cysts and a mild case of carpal tunnel syndrome.

Evening primrose, black currant and borage oils: These oils contain the fatty acid gamma-linolenic acid, which is useful for treating arthritic pain.

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 incorporated into fresh vegetable juice.

Dietary Changes to Fight Inflammation and Manage Your Pain

Physicians often fall short when attempting to effectively treat chronic pain, resorting to the only treatment they know: prescription drugs. While these drugs may bring some temporary relief, they will do nothing to resolve the underlying causes of your pain. If you suffer from chronic pain, making the following changes to your diet may bring you some relief.

Consume more animal-based omega-3 fats. Similar to the effects of anti-inflammatory pharmaceutical drugs, omega-3 fats from fish and fish oils work to directly or indirectly modulate a number of cellular activities associated with inflammation. While drugs have a powerful ability to inhibit your body's pain signals, omega-3s cause a gentle shift in cell signaling to bring about a lessened reactivity to pain.

Eating healthy seafood like anchovies or sardines, which are low in environmental toxins, or taking a high-quality supplement such as krill oil are your best options for obtaining omega-3s. DHA and EPA, the omega-3 oils contained in krill oil, have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief.

Radically reduce your intake of processed foods. Processed foods not only contain chemical additives and excessive amounts of sugar, but also are loaded with damaging omega-6 fats. By eating these foods, especially fried foods, you upset your body's ratio of omega-3 to omega-6 fatty-acids, which triggers inflammation. Inflammation is a key factor in most pain.

Eliminate or radically reduce your consumption of grains and sugars. Avoiding grains and sugars, especially fructose, will lower your insulin and leptin levels. Elevated insulin and leptin levels are some of the most profound stimulators of inflammatory prostaglandin production, which contributes to pain.

While healthy individuals are advised to keep their daily fructose consumption below 25 grams from all sources, you'll want to limit your intake to 15 grams per day until your pain is reduced. Eating sugar increases your uric acid levels, which leads to chronic, low-level inflammation.

Optimize your production of vitamin D. As much as possible, regulate your vitamin D levels by regularly exposing large amounts of your skin to sunshine. If you cannot get sufficient sun exposure, taking an oral vitamin D3 supplement, along with vitamin K2 and magnesium, is highly advisable.

Research by GrassrootsHealth suggests adults need about 8,000 IUs per day to achieve a serum level of 40 ng/ml, but you may need even more. It's best to get your blood level tested to be sure you're safely within the therapeutic range.

Bodywork Methods That Reduce Pain

The following bodywork methods have also been demonstrated effective for more lasting pain relief and management.

Acupuncture: According to The New York Times,36 an estimated 3 million American adults receive acupuncture annually, most often for the treatment of chronic pain. A study37 published in the Archives of Internal Medicine concluded acupuncture has a definite effect in reducing four types of chronic pain, including back and neck pain, chronic headache, osteoarthritis and shoulder pain — more so than standard pain treatment.

Chiropractic adjustments: While previously used most often to treat back pain, chiropractic treatment addresses many other problems — including asthma, carpal tunnel syndrome, fibromyalgia, headaches, migraines, musculoskeletal pain, neck pain and whiplash. According to a study38 published in the Annals of Internal Medicine, 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.

Massage: Massage releases endorphins, which help induce relaxation, relieve pain and reduce levels of stress chemicals such as cortisol and noradrenaline. A systematic review and meta-analysis39 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 bone and muscle, fibromyalgia, headache and spinal cord pain.

The study revealed 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.

Emotional Freedom Techniques (EFT): EFT continues to be one of the easiest and most effective ways to deal with acute and chronic pain. The technique is simple and can be applied in mere minutes, helping you to overcome all kinds of bodily aches and pains. A study40 published in Energy Psychology examined the levels of pain in a group of 50 people attending a three-day EFT workshop, and found their pain dropped by 43 percent during the workshop.

Six weeks later, their pain levels were reported to be 42 percent lower than before the workshop. As a result of applying EFT, participants felt they had an improved sense of control and ability to cope with their chronic pain. In the video featured below, EFT expert Julie Schiffman, teaches you how to use EFT to address chronic pain.

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