Filling In the Gaps on Pain Prescriptions
CommonHealth.WBUR.org
By Judy Foreman
Guest Blogger
Today’s New York times carries a front page article fanning the hysteria – once again – about prescription painkillers.
A prominent number quoted in the article – that, according to the federal Centers for Disease Control and Prevention, 14,800 people died in 2008 in episodes involving these painkillers – is correct. And that’s 14,800 too many. No doubt about it.
But look at what the article failed to say: That, again according to the CDC, half of all those deaths involving prescription painkillers also involved at least one other drug, including benzodiazepines, cocaine and heroin. And that “alcohol is also involved in many overdose deaths.” To blame it all on prescription painkillers – and pain patients and their doctors – is simply not the full truth.
The New York Times story also failed to note that, in contrast to the 14,800 people whose deaths involved prescription painkillers, 443,000 American adults die every year from cigarette smoking. And more than 80,000 die every year from excessive alcohol use. Non-prescription painkillers such as NSAIDS (non-steroidal anti-inflammatory drugs like ibuprofen) aren’t exactly benign, either – they kill an estimated 7,000 to 10,000 American adults a year.
Nor did the article mention the extent of suffering caused in this country by chronic pain.
According to a recent report from the Institute of Medicine, an estimated 100 million Americans live in chronic pain, and that doesn’t count children, people in the military or in institutions such as nursing homes.
And – estimates vary – one tenth to one third of them have chronic pain that is severe and disabling. At least some of this latter group do need opioids, probably strong ones, and possibly for the rest of their lives. To put too many barriers in the way of access to opioids is tantamount to what some ethicists call “torture by omission.”
Furthermore, the New York Times articles picks on doctors for overprescribing painkillers. But doctors are not the real problem.
If it’s diversion and abuse that you’re worried about, consider where street abusers actually get their drugs. According to a 2009 government report, 53.3 percent get their drugs free from a friend or relative, 9.9 percent buy them from a friend or relative, 5 percent steal them from a friend or relative. That’s roughly 70 percent who get it from your medicine cabinet and mine. (And yes, 17.6 percent get them from a doctor.)
To be sure, opioids are not perfect painkillers. In fact, by some estimates, they’re only 30 to 40 percent effective. And yes, of course, non-pharmacological treatments are essential (though not always reimbursed) for treating chronic pain, including meditation, exercise, distraction, acupuncture and massage.
Prescription painkiller deaths grab the headlines, and the front page stories. But all too often, the silent suffering of people in chronic pain does not.
Judy Foreman, perhaps the best-known health reporter in Boston and a nationally syndicated columnist, is writing a book about chronic pain titled “A Nation in Pain: Healing Our Biggest Health Problem.”
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Media Coverage
November 16, 2012
Physicians take lead role in confronting opioid misuse, but still face hurdles: This is the second in a series exploring the intersections between effectively caring for people living with chronic pain and the rise in unintentional poisoning deaths due to prescription painkillers. (The first post is here.) The series will explore the science and policy of balancing the need for treatment as well as the need to prevent abuse and diversion. This week’s story looks at clinical efforts to reduce the risk of opioid abuse and overdose while still caring for patients; the next story will explore the role of public health officials in curbing opioid abuse. Read More
November 14, 2012
AMA webinar spells out 8 ways physicians can curb opioid misuse: The Association holds the first in a series of webinars to teach doctors more about appropriate pain management. Read More
September 17, 2012
FDA Warns of Serious Skin Burns from Topical Pain Relievers: FDA Warns of Serious Skin Burns from Topical Pain Relievers Read More
July 3, 2012
Methadone deaths may have peaked, feds say: CDC » Doctors are more cautious about prescribing methadone for pain because of federal, state warnings. Read More
April 9, 2012
Filling In the Gaps on Pain Prescriptions: Filling In The Gaps On Pain Prescriptions Read More
April 5, 2012
Opioid Rotation Practices Linked to Fatalities: Opioid Rotation Practices Linked to Fatalities Read More
April 3, 2012
Switching Opioids Increases Risk of Overdose Death, Study Says : Switching Opioids Increases Risk of Overdose Death, Study Says Read More
April 2, 2012
Changing Opioids Causing More Overdose Deaths : Changing Opioids Causing More Overdose Deaths Read More
April 1, 2012
Doctors kill thousands due to 'death tables,' Utah expert says in new study : Reference tool responsible in death toll from prescription painkillers Read More
April 1, 2012
Opiate conversion charts killing patients : Opiate conversion charts killing patients Read More
March 8, 2012
What Whitney Houston Teaches Us: Whitney Houston has died from an as-yet unknown cause, but prescription medications are rumored. Her struggles with substance abuse are well documented, because she honestly shared them with the public in hopes of finding her road back. Celebrity deaths bring to our attention the national public health crisis with prescription drugs, and the list is growing: Health Ledger, Anna Nicole Smith, Corey Haim, Mike Starr. These people are not apart from or above us but hold a mirror up to our own lives. Most healthcare practitioners and counselors know a client, a friend or even a family member who has met the same tragic fate. Read More
March 2, 2012
LifeSource Co-Founder Lynn R. Webster, M.D. Receives Inaugural AAPM Presidential Excellence Award for Education: The American Academy of Pain Medicine initiates award to honor Dr. Webster’s work on the AAPM Safe Opioid Prescribing Initiative. Read More
January 12, 2012
The Chronic Pain Problem : Millions of Americans are affected by debilitating chronic pain, and diagnosis and treatment remain a challenge. Read More
November 2, 2011
Study shows Utah a leading state in painkiller deaths : A new study shows that painkiller abuse has not only reached epidemic levels in the United States, but overdose deaths continue a disturbing rise. Read More
November 1, 2011
Prescription Painkiller Overdoses in the US: Overdose deaths from prescription
painkillers have skyrocketed
during the past decade. Read More
September 14, 2011
Family: Player died from methadone overdose: Family members say a North Carolina high school quarterback died after a big victory last month after accidentally overdosing on some of his grandmother’s pain medication. Read More
August 26, 2011
Dr. Webster Pain Med Safety Interview: Host: Dr. Brian Grieves
Radio station # (715) 524-2194
About: Dr. Brian Grieves is a radio show host at WTCH-AM, an affiliation WOTE-AM, both radio stations at Wisconsin. Every Saturday he gives his professional advice on "Health Talk" to his avid listeners in Shawano. Prior to working as a chiropractor, Grieves earned his Bachelors degree from the University of Wisconsin, a doctorate degree from Northwestern College, and his Masters Degree in Public Health from the University of Massachusetts. Read More
June 30, 2011
Dramatic increase of prescription-drug abusers seeking treatment: Dr. Webster joins
KCPP to discuss trends in prescription drug abuse. Read More
June 23, 2011
'Rapid detox' a quick fix for opiate addiction?: USA Today Read More
June 15, 2011
LIFESOURCE ANNOUNCES NEW STUDY FINDINGS AVAILABLE ON DEATHS RELATED TO PRESCRIPTION OPIOD THERAPY: Nonprofit organization strives to address one of the nation’s biggest healthcare problems Read More
April 27, 2011
American Pain Foundation Announces New NSAID and Acetaminophen Pain Medication Safety Module and Public Service Announcement for PainSAFE Read More
April 20, 2011
U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?: U.S. Aims to Reduce Overdose Deaths, But Will the New Plan Work?
By MAIA SZALAVITZ Wednesday, April 20, 2011
The Obama administration announced on Tuesday a new initiative to reduce prescription painkiller Read More
April 19, 2011
Striving Toward Quality Pain Management: The epidemic of untreated chronic or recurrent pain has lasted for decades, yet millions of people are still not adequately treated. One significant barrier to effective pain management is that clinicians and patients are often reluctant to talk about pain... Read More
April 11, 2011
National Prescription Drug Abuse Expert From Utah To Present At Public Town Hall Meeting In Reading: Medical experts and law enforcement provide insights on adolescent prescription drug addiction Read More
March 22, 2011
National Prescription Drug Abuse Experts To Meet With White House Policy Makers: Experts will address prescription pain medication misuse and accidental overdose deaths with the White House Office of National Drug Control Policy Read More
March 10, 2011
National Prescription Drug Abuse and Overdose Deaths Expert Addresses Healthcare Professionals In Houston: Lynn R Webster, M.D. Read More
February 12, 2011
For Some Troops, Powerful Drug Cocktails Have Deadly Results: February 12, 2011
This article was reported by James Dao, Benedict Carey and Dan Frosch and written by Mr. Dao.
In his last months alive, Senior Airman Anthony Mena rarely left home without a backpac Read More
February 5, 2011
There are ways to help, prevent prescription drug abuse:
CHARLESTON, W.Va. -- Recently The Charleston Gazette ran a series on the emerging epidemic of prescription drug abuse. In a state with the highest rate of drug-related deaths, highlighting prescription drug abuse is an important public Read More
January 24, 2011
Morphine/Oxycodone Combination Superior to Separate Components: Montreal Read More
January 20, 2011
I Am An Addict:
Millions of older Americans are making this confession. Families are being torn apart. The good news: There's help Clean and sober for more than five years, Ron Dash has rebuilt his marriage and his life. “When I saw what Read More
January 10, 2011
Patients suffer when doctors are too scared to prescribe pain pills : Patients suffer when doctors are too scared to prescribe pain pills
Monday, January 10, 2011; 8:36 PM
Every American should be concerned about the kind of message sent by the Jan. 2 front-page article "Doctors who pre Read More
December 15, 2010
Chronic pain patients, providers get new website:
Kathy Hahn Read More
December 9, 2010
Should an Overdose Antidote Be Made More Accessible?:
I've been writing about naloxone — the antidote to overdose of heroin, oxycodone or similar drugs — for more than 10 years, most recently for TIME here. The dru Read More
November 9, 2010
Addiction to painkillers hobbles more patients : ST. LOUIS — Nichole Marie Case unwittingly became dependent on opioid painkiller drugs. She's not alone.
The National Institute on Drug Abuse estimated in 2008 that 1.85 million people in the United Stat Read More
October 25, 2010
Opioid safety is focus of $1 million-a-year educational initiative :
Opioid safety is focus of $1 million-a-year educational initiative
Industry-supported PainSAFE targets how physicians and patients can avoid abuses and misuses of pain treatments.
A group that represents patients living with pai Read More
February 11, 2010
The Effect of Academic Detailing on Curbing Opioid-Related Deaths in Utah
February 11, 2010
Root Cause Analysis for Unintentional Overdose Deaths Involving Opioids in Chronic Pain Patients Reveals Disproportionate Methadone Involvement
February 11, 2010
Costs of Oral Pain Medications Pre-IT Pump Implantation Compared to Post-IT Pump Implantation: A Retrospective Analysis
February 11, 2010
Select Medical-Legal Reviews of Unintentional Overdose Deaths
February 11, 2010
Comparison Of The Theoretical Cost Of Morphine And Prialt
November 18, 2009
To Help Healing, Doctors Pay More Attention to Pain. Morning Edition. National Public Radio.: The old notion that pain is somehow "good" for you should be put to rest for good, say health officials. They are increasingly recognizing that control of pain leads to more rapid recovery for hospitalized patients, and can even cut costs. Read More
November 28, 2006
National Expert from Utah Spearheads Educational Campaign: FDA Issues Methadone Warning: Providing Safe Access to Pain Medications.
SALT LAKE CITY, Utah – November 28, 2006 – The Food and Drug Administration issued a warning yesterday to healthcare profe Read More
October 24, 2006
Prescription Medication Deaths Are On The Rise: Six Steps You Should Know: National Expert Calls for "Zero Unintentional Deaths" with Brigham City Physicians
SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled Read More
October 18, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: National Education Campaign Comes to Brigham City Community Physicians.
SALT LAKE CITY, Utah – October 18, 2006 – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Directo Read More
October 18, 2006
National Expert Calls for Zero Unintentional Deaths: National Expert Calls for "Zero Unintentional Deaths" with Hawaiian Physicians
SALT LAKE CITY, Utah – National pain medicine expert Dr. Lynn R. Webster will present his education campaign entitled “Zero Unintentional Overdose D Read More
September 27, 2006
Methadone Related Deaths On The Rise : Six Steps You Should Know
SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announces six steps to avoid acci Read More
September 20, 2006
Local Pain Medicine Specialist Calls for Zero Unintentional Deaths: Statewide Education Campaign Goes National
SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, announced that h Read More
September 18, 2006
Local Pain Medicine Specialist Calls For Zero Unitentional Deaths: National Education Campaign Comes to St. George Community
SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® & Pain Clinic in Salt Lake City, a Read More
June 8, 2006
Dr. Lynn R Webster Kicks Off Statewide Education Campaign: LOCAL PAIN MEDICINE SPECIALIST CALLS FOR ZERO UNINTENTIONAL DEATHS
SALT LAKE CITY, Utah – Dr. Lynn R. Webster, President of the Utah Academy of Pain Medicine and Medical Director of Lifetree Clinical Research® &a Read More
