The production, marketing and prescribing of OxyContin and other similar drugs, called opioids, is one of the biggest health care disasters of our age.
The U.S. Centers for Disease Control has called the rise in opioid abuse an epidemic. This class of drugs now directly causes three out of four prescription drug deaths, and likely contributes to many more. In 2012, the number of deaths from these painkillers was 16,000, four times greater than in 1999.
The most obvious problem is addiction. While many patients take them without a problem, for others, these drugs are highly addictive. Some patients have noticed dependency signs within a week of starting them. These signs include craving the drug, compulsive thinking about the next dose, and symptoms of anxiety, depression, shakiness, and inability to sleep or think clearly when a dose is missed.
Despite the image of the young male as the main abuser of drugs, the highest prescription painkiller overdose rate is among middle-aged adults, according to the CDC. Once a person is addicted, they often turn to heroin, because it is cheaper than the prescription drug.
The problem is there is no good research on just how addictive these drugs are. The manufacturer of OxyContin, Purdue Pharma, came up with the number that fewer than 1 percent of users become addicted. However, it eventually came out that they falsified the original research, greatly minimizing how addictive the drug is.
This made it attractive to family doctors, orthopedists and pain specialists who are always looking for ways to ease patients’ pain. When Purdue was caught, the company was ordered to pay a $630 million fine, and the owner, lead researcher and attorney were personally fined over $64 million between the three of them. They narrowly avoided jail time. They also paid nearly $20 million to 26 states to settle complaints that the company encouraged physicians to overprescribe OxyContin.
Similarly, there are no good stats on how many current drug addicts started with a legitimate prescription. One small study of 75 addicts found that 41 percent started with a prescription for pain; many substance abuse counselors have noticed this trend as well.
There are other problems with these drugs. Long-term use can cause a reverse effect — rather than easing pain, the patient begins to have pain throughout the body. This is called opioid-induced hyperalgesia, in which algesia means pain, and we all know what hyper means. Besides the pain, there is usually fatigue and depression. Doctors using morphine for pain relief since 1870 have written about this effect. Once again, there are no good statistics on how common this problem is.
Also, even those who are not addicted can have a difficult time getting off these drugs after long-term use. The medications’ effects on brain chemistry can last t hree to nine months after they are withdrawn.
But these facts did not prevent the FDA from recently approving use of these medications on children as young as 11 years old, based on research supplied to them by — are you ready for this? — the manufacturer, Purdue Pharma.
While these drugs are very effective at treating pain, and many people can take them without a problem, they were originally limited to use for end-of-life pain control. But largely from pressure (and false evidence) from the drug manufacturers, their use has greatly expanded.
Like many drugs developed for chronic conditions, it looks like the side effects are worse than the disease itself. To start using them on children, whose nervous systems are still developing, seems a recipe for disaster, especially when there are so many alternatives for pain control. More on that next week.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at email@example.com.