According to a new report from the Center for Disease Control and Prevention (CDC), the number of opioid prescriptions written in the United States decreased for the first time since the beginning of the opioid epidemic in the late-90s.
Between 2012 and 2015, prescriptions for opioid painkillers fell by over 13 percent, from 81.2 per 100 people to 70.6. While the first drop in nearly twenty years is most definitely a positive sign, we’re far from eradicating this devastating crisis.
Even the CDC’s acting director, Dr. Anne Schuchat, warns readers of the data to curb any enthusiasm about this problem being close to solved. Schuchat stressed that painkiller prescription levels continue to be quadruple that of some of our European counterparts.
“It looks a little bit better, but you really have to put that in context,” Schuchat told the Washington Post in an interview. “We’re still seeing too many people get too much for too long.”
Our nation’s opioid addiction problem is rooted in the commercial nature of Big Pharma and the rampant over-prescribing that started in the early-to-mid-1990s. When Marijuana.com spoke to Dr. James Feeney, the Hartford, Connecticut trauma surgeon leading one of the first government-approved studies into the use of cannabis as a replacement for opioid painkillers in the treatment of acute pain, he credited the advent of the epidemic to the American medical community adopting physical pain as the “5th vital sign,” creating a culture where numb is normal.
Marijuana.com: Piggy-backing off of the recent Center for Disease Control study, what are your thoughts on the shift of opioid painkiller use to more harmful variants and how it’s prescribed?
Dr. James Feeney: Yes, I’m looking at that study right now, it is pretty interesting. I started medical school in 1996 and when I was in my first and second year, they introduced us to what was at the time a pretty new concept, pain as the 5th vital sign. It was just around this time when doctors were starting to take a real interest in a patient’s pain levels at all times. There was more of an emphasis on treating pain appropriately, but over the years of my training, what I’ve seen is that idea that pain is the 5th vital sign become more and more institutionalized; to the point where one of the questions nurses ask when a patient is admitted to the floor is, “what’s your pain score?” and patients all know exactly what that question means.
That probably started around the mid to late-90s and then turned into a line item on the patient’s bill of rights which was the patients have the right to adequate pain control. You have to think about that for a second because signs are something that doctors measure. In those intervening years, we completely took away the role of the physician to say to a patient, “I understand that you’re having a little bit of pain. I can’t take your pain completely away, but I can take the edge off.” My goal is to take the edge off a little bit so that you can function a little better in your daily life. Instead, we said, “you get to now decide if the pain control I’m giving you is enough,” and if the answer is “no,” then I have to give you more because it is a construct that we’ve developed in the patient’s bill of rights.
Over the last 10 or 15 years, we started tying physician compensation to how well they perform on patient satisfaction surveys. After a patient takes a survey, about 60 to 70% of those questions asked have to do with pain control. We really put ourselves into a corner when it came to pain control and the only thing we really have at our disposal to treat pain is opioid medication.
One of the other main issues with the CDC findings is the amount of time it takes the data to reach the public, as the most recent prescription data we now have from the CDC is still at least two years old. With so many lives at risk, it’s safe to say that the tracking of opioid prescriptions should happen in real time on a nationwide level so that the CDC doesn’t have to backtrack and collect old records from individual states. In 2015, over 33,000 lost their lives in an opioid overdose — almost half of which were killed by prescription painkillers directly. In that same year, Dr. Schuchat said there were enough painkillers prescribed to “provide every American with round-the-clock painkillers for three weeks.”
“Improving the management of chronic pain is very important,” Dr. Schuchat explained. “There are multiple approaches. Larger-scale studies suggest that opioids, even high-dose opioids, are not in the long run effective for chronic pain and in the long run may even be dangerous.”
By health insurance companies in the United States refusing to cover alternative therapeutic methods like medical marijuana for patients in pain, many individuals are effectively forced to use the only available and covered treatment option, which is typically opioid painkillers. When patients are prescribed the drug for an extended period of time, their chance of developing a gripping addiction skyrockets.
“If you are on opioids longer than three months, your risk of being addicted increases by 15-fold,” Dr. Schuchat added.
Cover Image Courtesy of Natural Society