[onlooker]

https://www.cdc.gov/drugoverdose/epidemic/index.html

[We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled,2 yet there has not been an overall change in the amount of pain that Americans report.3,4 Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.5

My question is, in light of this Epidemic, why do prescriptions continue to be issued at such a high rate. It is known that different ways exist of dealing with pain. Seems once again our for profit healthcare system is producing less than ideal outcomes

[Cog]

Treating symptoms is more profitable than affecting a cure.

[Tanada]

https://www.cdc.gov/drugoverdose/epidemic/index.html

[We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled,2 yet there has not been an overall change in the amount of pain that Americans report.3,4 Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.5

My question is, in light of this Epidemic, why do prescriptions continue to be issued at such a high rate. It is known that different ways exist of dealing with pain. Seems once again our for profit healthcare system is producing less than ideal outcomes

You are making the unwarranted assumption that pain was being properly treated before 1999.

Pain was often dismissed by medical professionals because it is entirely subjective unless you do testing to see how the patient moves and try diligently to determine what level of pain they are actually experiencing. The problem is not the 'over prescription of opioids' causing deaths. If a chronic pain patient dies of an overdose their are generally two reasons, the prescription was not relieving their pain without causing some other disability that was intolerable, or the patient had reached the end of their tolerance for living with constant discomfort and chose to end their life through deliberate overdose. Opioid treatment for pain have a long list of side effects, many of which make day to day encounters with other people difficult or embarrassing. It is also a well established fact that many people on the highest doses are terminal patients from some condition causing great pain like end stage cancer. Classifying all these deaths as 'opioid caused' is a way of twisting things around to make a situation look worse.

There have been a number of reports of patients losing access to prescription painkillers who turn to illegal drugs seeking relief. The harder you make it for people to function legally the more incentive you create for illegal activity. Is that what you really want to do?

[onlooker]

Informative reply T. No easy answer. This issue is subsumed within the larger issues of the profit healthcare system, the high addiction/drug use prevalence and the generally poor health of many Americans. Unfortunately, as things stand opiods have addictive qualities and heroin is a narcotic probably not so difficult to attain, so a bad combination there.

[Rod_Cloutier]

Psychedelics are so much better than Opiods. I had a rough week, my wife got fired from work and my boss is talking about eliminating my job soon. (It's being automated) So I took two tablespoons of nutmeg last night, and I'm good and stoned today.

I'd rather take Ayahausca, but it is highly addictive. People should switch to Psychedelics instead, their much better and less dangerous.

[KaiserJeep]

Full disclosure: I have had Rheumatoid Arthritis since diagnosed at age 28, and after a long series of treatments my symptoms were no longer manageable with anti-inflammatory drugs and various medicines prescribed by an endocrinologist to tweek the glands. There are low density bone growth in all my joints, my fingers have strange bulges, and I've had "pearls" of bone plucked from my feet, ankles, and knees via laproscopic procedures. I have had an opiod prescription for the last 48 months, which I use judiciously, since nobody but me is really aware of how much pain I am in. But if you were ever curious as to why I was posting at an ungodly hour of the morning, it was probably because the pain prevented me from sleeping. For the normal day to day pain I use a prescription NSAID called Voltarin ER, but I'm at the maximum dosage now, to take more is to risk liver damage, which to guard against my doctor takes blood for testing every three months.

So if I miss a nights sleep due to pain, I take a pretty potent Hydrocodone-Acetaminophen pill, so I don't miss a second night. But I don't take them regularly, only when needed. I do this because after missing two nights sleep, I feel and probably look like a zombie.

FWIW, my doctor gives me the usual twenty questions when he renews or adjusts my prescription. I have had an increase in both dosage and number of pills, I'm up to 50 pills per year now. He is a talented and responsible MD, and both he and I are taking care not to abuse this medication. But there may come a time when I have to stop taking Voltarin and take opiods every day.

[onlooker]

Wish you the best with your malady Kaiser.

[KaiserJeep]

Squilliam, I think you are correct but don't have the whole story. It is true that too many legitimate prescriptions exist, because some doctors overprescribe opiod painkillers. But there are few that are abusing opiods from only legal sources. There is a huge influx of illegal opiods from our Southern Border, it's a massive problem almost the equal of the crack cocaine problem.

The pills being smuggled in are largely made by US manufacturers and then legally sold in Mexico, where corruption in government exists, most pills get smuggled North into the US and if you carry them around in your legal prescription bottle, the authorities cannot tell whether you are taking 50 pills per year or 50 per week, which would be a bad drug dependancy, especially if you were crushing the pills and injecting, or smoking, or snorting the powder up your nose. There are also potent Hydrocodone fake pills that look just like legitimate US production, but contain heroin or even synthetic painkillers intended for veterinary use.

The social ills you mention do not help, but in my personal experience, if a person has a drug dependancy, having more money only makes it worse.

Edit: The OP did in fact misspell "opioids", as did all of us since.

[onlooker]

So its become a quasi-legal or illegal operation

[KaiserJeep]

Make no mistake, all the opioids (codeine, fentanyl, hydrocodone, hydromorphone, meperidine (Demerol), methadone, etc.) are controlled substances, and you break the law when you possess or take them without a prescription, or you take more than the prescribed amount. It is also unsafe to self-prescribe these drugs, unless you have a medical license - and the doctors themselves are being closely scrutinized by the DEA, my doctor has a "special" prescription form for controlled substances.

Yes, we still have a problem in spite of this. But speaking as one whose quality of life would be degraded without effective painkillers, please be careful.

[SeaGypsy]

Rod is the only person I ever met who finds DMT addictive - I've been around it for over 20 years, know hundreds of people who have used it, none who have become addicted. DMT is not a painkiller, nor are other well known psychedelics. There is some evidence that using psychedelics once, twice or thrice can assist forming neural pathways which may assist patients in overcoming, not curing, chronic pain.
There is far more evidence that cannabis is worthwhile as a pain medication, not physically addictive & mild side effects compared to opoids.

I worked in palliative care for years, Tanada is spot on- if people are dying anyway, end up dying soaked in morphine- & not in pain- that is a completely separate issue to suicides & supposedly accidental overdoses.

[KaiserJeep]

SG, nothing to disagree about in what you said, but there is still a problem with opioid abuse. How can we take away people's pain while solving the abuse problem?

[onlooker]

Yet, many around the world have a scarcity/excruciating pain problem
"Globally, such situations are far more common than the overuse seen in America. In poor and middle-income countries, people suffering from cancer and other terminal illnesses often die excruciating deaths with minimal relief. The International Narcotics Control Board (INCB), an independent monitor that oversees the implementation of UN drug conventions, estimates that 92% of all morphine, an opioid commonly used to control the pain caused by cancer, is consumed in America, Canada, New Zealand, Australia, and parts of western Europe—which between them hold only 17% of the world’s population. “It’s an absurd situation,” says Dr Fischer, the Canadian professor. “We’re spraying [opioids] from a fire-hose while the majority of the world doesn’t have them.”

[SeaGypsy]

Kaiser- Drug abuse occurs when people find their lives intolerable for myriad reasons, some medical, others social & economic. I don't believe there is an answer as such. Ban opoid self administration altogether & alcoholism will go through the roof, besides black market opoids becoming an even greater opportunity for criminals. My opinion is addiction & abuse are going to get worse, not better- as people have been brought up soft & believing life owes them a comfortable & easy existence. It doesn't, & as we march on multiplying & consuming, running out of stuff to consume, yet raising people in a fantasy bubble.... Best can happen is harm reduction, education, social alternatives to chasing rainbows.

[KaiserJeep]

One other fact needs to be discussed. Opioid drugs are made from opium poppies, period. Even the so-called "synthetic opioids" are not made from scratch, they start with codiene or morphine which are derived from opium poppies, and then chemically alter it to increase potency.

Opium can be legally grown in India, Turkey, and the Australian state of Tasmania, with Tasmania being the biggest legal supplier. Illegal opium is grown in Afghanistan, Pakistan, Burma, and Thailand, with about 90% of the illegal opium coming from Afghanistan, where the opium trade supports many a tribal warlord. Heroin is a relatively easy to manufacture opium derivitive, and the chosen drug of many.

Opioid junkies are found in First, Second, and Third world countries. Those who use Heroin in particular support the violence in Afghanistan. Those who abuse the synthetic opioids Hydrocodone and Oxycodone support Tasmania.

[Rod_Cloutier]

DMT is not a painkiller, nor are other well known psychedelics

Never said it was. The question is why is there a growing problem of opioid use and abuse? Society is changing rapidly, too rapidly for most to adapt, myself included. My implication is that Psychedelics would be better escape drugs to take than abusing opioids.

Also, if you've ever used DMT personally you will know that nothing in waking life approaches the bliss of this drug. Hence it is addictive. The first time I used Ayahuasca it was like taking the best orgasm I ever had, multiplying it by a thousand, and then experiencing this state non stop for 6 hours. I've had morphine in the hospital before for kidney stone treatment. Morphine doesn't even remotely compare to the bliss of psychedelics.

People are using the wrong drug.

[SeaGypsy]

Yeah but that's not how it works, if you keep doing DMT or other psychedelics, the effect diminishes rapidly towards the point of just ingesting a toxin with no therapeutic benefit or affect. I have never felt inclined to keep doing more & more of any psychedelics & I've had just about all of them several times each. As i mentioned above, psychedelic addiction is rare, because the diminished returns are obvious. Regards vs opoids, i would agree psychedelics can open new doors of perception which can lead beyond the need for obliterated consciousness, but many people are deeply triggered by psychedelics to the point they will only ever do them once- very common scenario due to the ego shattering involved.

[WildRose]

Through my work I've noticed that doctors in pain clinics are doing their best to steer patients away from opioids. It's difficult for the physicians as well, trying to come up with the best plan to manage their patients' chronic pain. Some patients go to appointments demanding opioids (in no uncertain terms) while their doctors are attempting to respond to the societal call to reduce their use. In the place of opioids, things such as exercise, yoga, meditation, and good social supports (in the form of personal relationships, psychological services) are recommended. Every case is unique, so it's a challenge to find what works for each person.

[SeaGypsy]

Totally WR, also the 15 minute turnaround pressure for general practice doctors doesn't help. If I've got anything serious to talk to a doctor about I always book a double appointment, half an hour is a much better time to dig into things than 10-15 minutes. Absolutely agree on the yoga & alt therapies aspects especially with pain management.