Pain Medication is Big Business– $US1.4 Trillion, 4.5 Trillion Doses: Pain Pills Kill Pain, But They Also Kill People…

Pain, pain medication, pain management is big business… everyone has pain whether it be acute, chronic… it’s an individual struggle… According to Institute of Medicine (IOM); over 100 million adults in U.S. have chronic pain and worldwide upwards of 1.5 billion individuals suffer from pain related to various ailments…

Pain has an illusive definition– it’s subjective, multifaceted, bio-psycho-social experience… Most people take some type of pain medication to mitigate the effects of pain, and there are three common types of pain relievers; non-steroidal anti-inflammatory drugs (NSAIDS), paracetamol, opioids…

Opioids have been regarded for millennia as among most effective drugs for treatment of pain… Their use in the management of acute severe pain and chronic pain related to advanced medical illness is considered standard of care in most of the world. In contrast, long-term administration of an opioid for treatment of chronic non-cancer pain continues to be controversial…

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Opiates cover a huge variety of drugs, ranging from legal drugs, such as; fentanyl, codeine, morphine… to illegal drugs, such as; heroin, opium… The terms ‘opiates’ and ‘opioids’ are often used interchangeably… Opiate addiction is a major issue in U.S., with prescription opiate addiction being one of the biggest drug problems today. Opiate medications are surprisingly easy to obtain and, prescription opiate abusers are far more likely to eventually develop a heroin addiction than a non-opiate abuser… since heroin offers a similar high at a cheaper price…

Every day, 52 people die from opioid pain medications… every year 47,000 die from a drug overdose, mostly from prescription pain medication… Opioids are being over-prescribed: And, it’s not people just reaching into medicine cabinets who have made drug poisoning #1 cause of unintentional death in U. S. adults; its people who have been over-prescribed opioids by doctors, and subsequently become addicted, and many move from pills to heroin…

Perhaps even more alarming; 70% of people who abuse prescription pain-killers reported getting them from friends or relatives. The numbers are staggering: In 2014 National Survey on Drug Use and Health report; there are 4.3 million current non-medical users of painkillers. Nearly 2 million people have pain-killer substance use disorders… According to Don Teater; pain killers don’t kill pain, they kill people…

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In the article Can the U.S. Win the War On Opioids? by Leigh Anderson writes: Remember the ‘war on drugs’? This may conjure images of drug lords, packages of smuggled cocaine, or clandestine DEA agents. But now the real bandit is found right in your own home– in bathroom medicine cabinets… According to Centers for Disease Control (CDC); 44 people die from over-dose of prescription opioid pain-killers each day…

These are everyday people– mothers, fathers, young people… Not because they went outside of the legal boundaries to use illicit drugs, but because they were caught-in web of prescription drugs addiction, accidental over-dose… Yes, there is much blame: healthcare providers, policy makers, patients… Here are some sobering U.S. statistics:

  • More people now die from prescription pain-killers than from car accidents…
  • Opioids are class of drugs that include; illicit drug heroin and licit prescription pain relievers– oxycodone, hydrocodone, codeine, morphine, fentanyl…
  • It’s estimated that 23% of individuals who use heroin develop opioid addiction…
  • Drug overdose is leading cause of accidental death in U.S., with 47,055 lethal drug over-doses in 2014. Opioid addiction is driving an epidemic, with 18,893 over-dose deaths related to prescription pain relievers, and 10,574 over-dose deaths related to heroin in 2014…

In the article Explosion in Overdose is Changing How Doctors Treat Pain by Harrison Jacobs writes: All of the attention on opioid crisis has major unintended consequence, many doctors are now increasingly wary of prescribing opioids… According to Dr. Ted Cicero; physicians are becoming hesitant to prescribing these drugs because of the bad publicity surrounding the abuse…

This development is just latest turn in decades-long saga that is modern pain-management… According to National Institute on Drug Abuse; the increased acceptability and commonness of opioid treatment led to an explosion in prescriptions, as well as, development of ‘pill mills’– shady pain clinics whose sole purpose is to prescribe legal opioids without asking too many questions…

Before long U.S. was flush with opioids and by 2011, 219 million opioid prescriptions were being handed out each year… In recent years, the media and government focus on the opioid crisis has shifted to the explosion in heroin users, but some doctors say the crisis has also led to a major change in pain treatment… According to Dr. Houman Danesh; the pendulum in the 1990s was definitely swung all the way in one direction with doctors over-prescribing opioids for everything… Now the pendulum is swinging in the opposite direction with many doctors refusing to prescribe opioids for anything…

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In the article Opioid Epidemic Myths by Jacob Sullum writes: The CDC says; health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every adult in the U.S. to have a bottle of pills… That year CDC counted about 16,000 deaths involving opioid analgesics, or one for every 16,000, or so prescriptions… Opioid-related deaths are rare even for patients who take narcotics every day, for years. The CDC cites; a study of patients aged 15–64 years receiving opioids for chronic non-cancer pain who were followed for up to 13 years…

According to NSDUH; 259 million pain-killer prescriptions in 2012 resulted in about 2 million cases of– dependence or abuse or one for every 130 prescriptions… only a quarter of people who take opioids for non-medical reasons get them by obtaining doctor’s prescription… Hence the sequence that many people imaginepatient takes narcotics for pain, gets hooked, and eventually dies of an overdose— is far from typical of opioid-related deaths… The researchers found that one in 550 patients died from opioid-related over-dose, which is risk of less than 0.2%– meaning risk of addiction is greatly exaggerated…

Pain is big business: According to UN World Drug Report; U. S. makes up about 5% of world’s population, yet consumes more than 75% of the world’s prescription drugs… The most abused prescription drugs fall under 3-categories: pain-killers, tranquilizers, stimulants…

According to National Institute on Drug Abuse; enough prescription pain-killers were prescribed to medicate every U.S. adult every four hours for a month… The biggest eye-opener is that keeping people on prescription drugs is a big money-maker… It’s no secret the pharmaceutical industry rakes in billions of dollars producing drugs to– treat symptoms, manage medical conditions, relieve pain…

The pharmaceutical market is headed for $1.3 trillion, and the global pharmaceutical industry is projected to grow markedly through the decade, reaching $1.4 trillion and 4.5 trillion doses of medicines by 2020… the emerging markets will account for 30% of the global pharmaceutical market share and it will reach $358-$388 billion in sales by 2018… Given its large population (70% of world’s population), growing middle class, increasing healthcare demands, it provides a rosy picture for growth and profit… Largest markets for pharmaceuticals based on sales are: U.S., EU, Japan, China, India… and these countries will account for over 60% of the global market well into 21st century…

However, there seems to be an inherent disconnect between legitimate business goals of pharmaceutical companies, and the needs and safety of consumers… According to Ben Goldacre in his book, ‘Bad Pharma’; declares ‘medicine is broken’ and ‘drug industry doesn’t work’– doctors are kept ignorant about drugs they prescribe… pharmaceutical firms routinely bury unflattering trial results and publish only the good ones… drug trials are run on unrepresentative patients with dodgy statistical analysis, and then pushed on doctors with advertising budgets that are often bigger than firms’ research-development budget…

Side note: According to OpenSecrets.org; pharmaceutical industry spends more than any other industry group each year to influence Washington lawmakers, e.g.; over $US2.6 billion on lobbying activities, in last decade… To get some perspective, consider that oil/gas industry spent over $US1.4 billion… defense/aerospace industry spent over $US662 million.. during same time period…

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Meanwhile, medicine’s guardians– regulators, scientific journals, professional bodies, academic establishment– turn a blind eye… The net result is that– doctors prescribe in ignorance, drug prices are outrageous, patients are harmed, and vast amounts of money are wasted. According to Sabriya Rice; people are led to believe by– doctors, advertisers, pharmaceutical industry– that there is ‘magic pill’ that will cure just about anything that ails them…

Prescription drug usage continues to rise and typical medicine cabinet is lined with multiple prescription pill bottles, and life for many people is nothing more than big bag of pills… The worlds of– pharmaceuticals, doctors, regulators, consumers… must find– different solution, better solution…The pharmaceutical solutions that worked in the 20th Century will not work in the 21st Century…