Opioid Addiction Now Surpasses Smoking

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.