By Dr. Mercola
Earlier this year, Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy stated that the use of narcotic painkillers and other opioids is "having a devastating impact on public health and safety in communities across the nation."1
The powerful drugs, which have their place in treating short-term severe pain, such as that which occurs after surgery or serious accidents, are now widely used for treating chronic pain problems, like headaches and back pain.
As pain is one of the most common health complaints in the US, record numbers of Americans are, sadly, now becoming drug addicts in an attempt to live pain-free. According to 2010 data, there were enough narcotic painkillers being prescribed in the US to medicate every single adult, around the clock, for a month.2
By 2012, a whopping 259 million prescriptions for opioids and other narcotic painkillers were written in the US, which equates to 82.5 prescriptions for every 100 Americans.3 We've been seeing the fallout from this overprescribing for a number of years now, but new federal data revealed that the problem is getting worse instead of better.
Deaths from Narcotic Painkillers Rise Four-Fold in a Decade
A report from the US Centers for Disease Control and Prevention (CDC) revealed that deaths from overdoses of drugs like hydrocodone (Vicodin), morphine, and oxycodone (Oxycontin) rose from 1.4 per 100,000 in 1999 to 5.4 per 100,000 in 2011.4 This equates to about 3,000 such deaths in 1999 and close to 12,000 just over a decade later.
Despite the significant jump, the report's co-author, Dr. Holly Hedegaard, an epidemiologist at CDC's National Center for Health Statistics (NCHS), pointed out that the rate of increase has slowed from about 18 percent a year in 2006 to 3 percent a year more recently.5 Still, the rate is still on the rise, and increases among certain populations were striking. For instanc
- Among people aged 55 to 64, deaths from prescription narcotic overdoses increased from one per 100,000 people in 1999 to more than 6 per 100,000 in 2011
- The number of opioid deaths among white people increased by 4.5 times during the study period
- The number of opioid deaths among African Americans doubled during the study period
Opioids Combined with 'Benzos' Make Up More Than 30 Percent of Narcotic Deaths
Opioids aren't the only type of narcotic included in the CDC data. Benzodiazepines such as Xanax, which are sedatives used to treat anxiety and insomnia, accounted for 31 percent of the narcotic overdose deaths in 2011 (up from 13 percent in 1999). Separate research shows that the use of "benzos" has risen alongside the use of opioids, and the sedatives are often used alongside the painkillers to enhance the "high."6
If you're wondering just how deadly opioids and benzos can be, earlier this year the state of Ohio used an opioid/benzo mix in a death-row execution after it couldn't obtain the conventionally used drugs.7
Despite their known risks, preliminary research presented at the 2014 meeting of the American Academy of Pain Medicine in Phoenix, Arizona also found that 12.6 percent of all primary care visits made by Americans between 2002 and 2009 involved prescriptions for sedatives and/or narcotic painkillers (opioids).8 The study also found:
- The number of prescriptions for sedative drugs rose by 12.5 percent a year
- Patients receiving a narcotic painkiller were 4.2 times more likely to receive a second prescription for a sedative
- The number of joint prescriptions of opioids and sedatives also increased by 12 percent a year in that time frame
- Prescription sedatives and narcotic painkillers are responsible for at least 30 percent of narcotic painkiller-related deaths
- Besides deaths caused by overdose, other risks associated with sedative use include falls in the elderly, emergency room visits, and drug dependence
Drug Companies Sued for Creating an Epidemic of Prescription Drug Abuse
Chicago and two California counties—Orange and Santa Clara—have filed a lawsuit against five drug companies that manufacture OxyContin, charging them with contributing to an epidemic of drug abuse. The two California counties are suing on behalf of the entire state.
In Santa Clara County, the death rate for opioid overdoses has tripled in the last decade, and according to assistant County Counsel Danny Chou, this is all due to a "decades-long marketing plan" by drug companies "to create a market for these drugs that never should have existed" in the first place.9
According to Chou, Santa Clara spends millions of dollars to treat overdoses and addiction in its public hospitals, and he wants the drug makers to pay for these costs—just like tobacco companies were forced to pay after being sued in the 1990s.
The lawsuit accuses the drug companies of purposefully downplaying the risks of these drugs, and secretly funding front organizations, like the American Pain Foundation, to promote the use of painkillers.
Interestingly, a 2011 Journal Sentinel/MedPage Today investigatio discovered that a University of Wisconsin-based organization called Pain & Policy Studies Group—which had received $2.5 million from makers of painkillers over the past decade—had been a "national force" pushing for expanded use of opioids.10 This group has also warned against increasing regulations of these dangerous drugs.
The largest funder of the UW Pain Group was Purdue Pharma, which donated about $1.6 million to the group. Purdue actually ended up having to pay fines and restitution payments to the tune of $635 million after the US Department of Justice accused the company of misleading doctors with fraudulent claims back in 2007. The company promoted OxyContin as "less addictive, less likely to cause withdrawal, and less subject to abuse" compared to other pain medications—claims for which they had no proof.
Intense Drug-Company Marketing of Opioids Goes Back to the 1950s
The epidemic of prescription overdose deaths is a relatively new problem, but it's one that been decades in the making, as reported by a Journal Sentinel/MedPage Today investigation.11
"There is little to no evidence demonstrating the efficacy of opioids for chronic pain -- and even less to support the use of opioids plus benzodiazepines, yet as far back as the late 1950s, drug companies ramped up large-scale marketing efforts. The cornerstone of that marketing blitz was a series of advertisements in prominent medical journals directed at doctors -- a campaign that continued through the 1980s.
A Journal Sentinel/MedPage Today review of the ads found they often made questionable claims that tranquilizers were good for ailments including menopause, gastrointestinal problems, ulcers, and cardiovascular symptoms. In the case of benzodiazepines, institutionalized dispensing of the drugs over the years also is linked to promotional activities of drug companies, a Journal Sentinel/MedPage Today investigation found."
Children are Also at Risk from Opioids and Benzos
About 9,500 children younger than 6 are hospitalized each year after ingesting family members' medications. Among them, three-quarters are between the ages of 1 and 2. Likely echoing the sharp rise in adults' use of opioids and benzodiazepines, both opioid painkillers and benzos topped the list of medications most often responsible for young children's hospitalizations.
And in terms of single active ingredients, the most common implicated in children's hospitalizations was buprenorphine, a narcotic that, ironically, is used in medications to treat addiction to opioids. That was responsible for 8 percent of the hospitalizations alone.12 According to the study:13
"Emergency department visits and subsequent hospitalizations of young children after unsupervised ingestions of prescription medications are increasing despite widespread use of child-resistant packaging and caregiver education efforts… Opioids (17.6%) and benzodiazepines (10.1%) were the most commonly implicated medication classes."
The researchers stated that "focusing unsupervised ingestion prevention efforts on medications with the highest hospitalization rates may efficiently achieve large public health impact," but an even better solution may be to curb the rampant overuse of these powerful medications in the first place.
19 Non-Drug Solutions for Pain Relief
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 is a very real concern. CDC Director Tom Frieden, put the serious danger of using narcotic painkillers even one time into perspectiv "Patients given just a single course may become addicted for life," he recently warned.14 Below, I list 19 non-drug alternatives for the treatment of pain. These options provide excellent pain relief without any of the health hazards that prescription (and even over-the-counter) painkillers carry. This list is in no way meant to represent the only approaches you can use.
They are, rather, some of the best strategies that I know of. I do understand there are times when pain is so severe that a prescription drug may be necessary. Even in those instances, the options that follow may be used in addition to such drugs, and may allow you to at least reduce your dosage. If you are in pain that is bearable, please try these first, before resorting to prescription painkillers of any kind. And if you are considering a benzodiazepine for anxiety, please try these natural solutions for anxiety first.
- Medical cannabis has a long history as a natural analgesic.15 At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids. As discussed in this previous post, 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. The Journal of Pain,16 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis. This is clearly the single most effective strategy that I know of as an alternative to reliance on narcotics for pain. If I had severe pain I would do everything I could to make sure I had legal access to this.
- 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, they manipulate prostaglandins.)
- 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.
- Emotional Freedom Technique (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, 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.
- 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. For more information about this groundbreaking technology, and how it can help heal chronic pain, please listen to my previous interview with Dr. Harrington.
- 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 can also effectively treat many kinds of pain. Research has discovered a "clear and robust" effect of acupuncture in the treatment of: back, neck, and shoulder pain, osteoarthritis, and headaches.
- Physical and massage therapy has been shown to be as good as surgery for painful conditions such as torn cartilage and arthritis.
- 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 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 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.17
- 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 mild 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, meditation, hot and cold packs, and other mind-body techniques can also result in astonishing pain relief without any drugs.
- Grounding, or walking barefoot on the earth, may also provide a certain measure of pain relief by combating inflammation.