Learn How Proper Pain Management Can Prevent Opioid Addiction
In 2015 there were 240 million opioid prescriptions written in the U.S., which is nearly one prescription for every adult in the country. Opioids are commonly prescribed for pain management, but a large portion of the Americans who use opioids don’t really need them.
Though illicit substances like heroin and carfentanil are also opioids, the U.S. opioid crisis is mainly being driven by the overprescribing of painkillers like oxycodone and hydrocodone. Roughly 40% of all opioid overdose deaths in the U.S. involve a painkiller— which has forced the country to take a closer look at ways people can safely manage pain without putting themselves at risk.
Here’s how painkillers are driving the opioid epidemic, along with insight on how you and other U.S. citizens can start viewing pain management to prevent any risk of opioid addiction.
How Painkillers are Contributing to the Opioid Epidemic
Sales of prescription opioids in the U.S. nearly quadrupled between 1999 and 2014 in tandem with the rate of deadly opioid overdoses. During that same period, roughly 200,000 people died from painkiller overdoses. How did prescription opioid abuse become such a serious problem?
Aggressive Pharma Marketing
Painkiller use in the U.S. didn’t become problematic until 1996 when Purdue Pharma started selling oxycodone under the brand name OxyContin. The drug was aggressively marketed to physicians, pharmacists, and patients throughout the late 1990s and early 2000s — with sales growing from $48 million in 1996 to nearly $1.1 billion in 2000. OxyContin sales reps were even given incentives in the form of cash bonuses that exceeded their average annual salaries of $55,000.
In 2001, every OxyContin sales rep earned an average bonus of $71,000.
Despite being a potent painkiller with roughly twice the strength of morphine, OxyContin was heavily marketed to the “non-malignant pain” market — meaning the drug was made available to nearly anyone suffering any level of pain. This led to an almost 10-fold increase in the number of OxyContin prescriptions for treatment of non-cancer related pain from 1997 to 2002. Today, up to one in every four people who use painkillers long-term to treat non-cancer pain are suffering from opioid addiction.
Purdue Pharma recently announced it is no longer marketing painkillers to doctors — a decision that was made only after the company has faced hundreds of civil lawsuits for overstating the benefits of painkillers, and understating risks such as addiction and overdose. Purdue has reported laying off 50% of their opioid sales reps and has committed to backing off on marketing to help fix the opioid crisis.
Opioids are usually routinely prescribed as part of surgery aftercare for procedures such as knee replacement, colectomy, gallbladder removal, and hysterectomy. But new evidence shows that post-operative pain can be effectively managed with alternative therapies like acupuncture, massage, and electrotherapy that carry little to no risk for addiction. Over-the-counter non-opioid drugs like acetaminophen and ibuprofen have also proven useful in helping patients manage postoperative pain.
Before 2016, many doctors resorted to using opioids as a first level pain treatment in surgery aftercare without considering other options. In 2016 the CDC released updated opioid prescribing guidelines urging physicians to take extra caution when prescribing painkillers. The guidelines also suggested doctors try using other pain treatments before turning to opioids.
Unfortunately, when doctors prescribe painkillers as part of surgery aftercare, they often prescribe too many — meaning patients often end up with leftover pills. Having leftover painkillers on hand increases the risk for prescription opioid abuse since the pills are no longer being used for any legitimate medical reason. Surgery aftercare is now a risk factor for opioid addiction due to the overprescribing of unneeded painkillers.
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Between 67 and 92% of surgery patients who use opioids to manage postoperative pain end up with extra pills, but only 10% of those people dispose of their leftover pills as recommended. This results in extra, unused painkillers being stored in medicine cabinets where they can be easily accessed and used by anyone in your home — including friends, family members, and children.
A study conducted at John Hopkins University found that many patients who are prescribed opioids after surgery decide to stop using the drugs because they’re able to adequately manage pain without opioids. Between 16 and 29 percent of patients involved the study reported that they stopped using opioids due to unpleasant side effects such as nausea, vomiting, and constipation. This evidence shows that doctors are prescribing opioids that aren’t even being used, and that are putting patients and their loved ones at risk for dependence, addiction, and overdose.
It was even found that surgery patients who take fewer painkillers at lower doses can recover from surgery just as comfortably as those prescribed a higher number of painkillers at higher doses. Many times, people who abuse painkillers or who use more than needed can actually become more sensitive to pain since increased pain sensitivity is a common side effect of opioid tolerance.
America’s Problematic Prescribing Practices
The U.S. prescribes more painkillers than any other country in the world. The standard daily opioid dose for every million people in the U.S. is 50,000 doses. Though the U.S. makes up only 4.4% of the global population, the country consumes 30% of the world’s opioid supply.
While the overprescribing of opioids in the U.S. may seem like an easy problem to resolve, there are many roadblocks deterring doctors from other pain management treatments. For instance, suggesting that patients manage pain using alternative therapies like massage and acupuncture could cause doctors and medical practices to lose patients to other specialists. Or, patients who experience persistent chronic pain after being barred from painkillers can leave negative ratings for doctors on healthcare surveys and review websites that can affect a medical practice’s bottom line.
Here’s a look at the scope of problematic prescribing practices in the U.S.
Supporting Unrealistic Pain Expectations
Having to endure any level of pain caused by an accident, illness, or surgery is sometimes inevitable, and also very normal. Invasive surgeries that require incisions and anesthesia will almost always result in some level of pain, even if you’re taking painkillers. Many doctors say their patients often have unrealistic expectations surrounding pain and assume that advancements in medical technology and medicine can prevent them from experiencing any pain at all.
In an effort to please and retain their patients, doctors admit they sometimes cater to their patients’ unrealistic pain expectations and requests for additional opioids. Unfortunately, this behavior puts patients unknowingly at risk for opioid addiction. Today, more doctors around the U.S. are working on reducing the number of opioid prescriptions by informing patients that pain can be expected and that painkillers can only help relieve some pain temporarily.
There are safer ways to manage pain; get help for opioid dependence today!
Boosting Patient Reviews and Ratings
The Internet now plays a major role in how patients choose hospitals and doctors thanks to patient review websites like Healthgrades, Yelp, and Google Reviews. Surveys show that 84% of patients visit these types of websites to rate and evaluate their doctors and that 77% of patients rely on online reviews when choosing a new doctor. Plus, hospitals are usually graded on their ability to reduce someone’s pain — meaning doctors are often under lots of pressure to keep patients comfortable and pain-free.
When it comes to the prescribing of painkillers, doctors are often stuck between meeting the demands of their healthcare institutions and looking out for their patients’ best interests. Doctors who refuse to prescribe unneeded painkillers or who use other pain management treatments may face a backlash from both hospitals and patients — the latter of whom may also leave negative feedback online. For instance, a medical center in New Jersey recently received a low one-star Medicare rating for emphasizing non-opioid pain treatments — urging Medicare to revise its pain questions on member surveys.
Promoting Opioids for Kickbacks
Doctors in European countries say opioid addiction is a problem in the U.S. because healthcare is more of an industry, and not as tightly regulated as in other countries like Denmark, Norway, and France. The U.S. is one of two countries in which prescription drugs like opioids can be legally marketed directly to consumers, which is why it’s not too surprising that the U.S. consumes more opioids than any other country in the world. This practice, known as direct-to-consumer pharmaceutical advertising or DTCPA, was legalized in the U.S. during the 1960s.
In many other countries, doctors receive salaries and aren’t paid extra based on the number of drugs they prescribe. But in the U.S., many doctors are teamed up with pharmaceutical companies who award large payouts to physicians who prescribe a higher number of certain drugs. Analysis conducted by a firm called ProPublica found that drug companies paid out $3.5 billion to U.S. doctors between 2009 and 2013. According to the report, doctors who earned money from pharmaceutical companies prescribed a higher number of brand-name drugs than doctors who didn’t earn rewards.
Rethinking Pain Management Can Prevent Opioid Addiction
Opioids have been America’s top pain management treatment for over 20 years. But reshaping the way Americans manage pain can help lower opioid addiction rates, and help the country overcome its deadly opioid crisis.
Here’s the latest news surrounding opioid treatment that may help change the way you view these drugs as they relate to pain management.
Opioids are Linked to a Higher Infection Risk
A recent study conducted at Vanderbilt University found that opioid use increases one’s risk for life-threatening infections like pneumonia and meningitis. Long-term opioid use can suppress your immune system, and make you more susceptible to illness, disease, and serious infections. The risk for opioid-induced health problems goes up substantially when users inject the drugs using dirty needles.
Opioids are only intended for short-term use in treating pain and are not to be used long-term for more than 10 days since doing so increases the risk for dependence and addiction. Using low-dose painkillers for just a few days won’t necessarily increase the risk for infection, but long-term prescription opioid abuse can cause infections, along with adverse side effects such as increased sensitivity to pain, vomiting, and depression.
Non-Addictive Painkillers Are in the Works
Scientists recently discovered a way to make non-addictive painkillers that only reduce pain without binding to receptors that cause euphoria. Traditionally, painkillers bind to all opioid receptors in the brain to produce pain relief, sedation, and euphoria — the latter of which increases the risk for opioid addiction. The new non-addictive painkillers are still in development and must be tested for efficacy in animal and human trials before they can be made available to the general population.
Leftover Painkillers Can Be Easily and Safely Disposed
Many Americans who end up with leftover painkillers usually store them in medicine cabinets out of convenience without being aware of related risks. Others assume that prescription drugs are safe for anyone to use since the drugs are legal and come from doctors, and peddle them off to friends, family, and neighbors in need of pain relief. But using prescription opioids without a valid prescription or using the drugs in ways other than directed is illegal and can lead to dependence, addiction, and overdose.
Today, a number of pharmacies, police stations, and hospitals are making it easier than ever for Americans to dispose of their leftover painkillers. Walmart recently started offering a free product to opioid users called DisposeRX that turns leftover pills into a useless gel. Some Walgreens Pharmacy locations offer safe medication disposal kiosks, while fire stations and police stations in many cities host drug take-back events to collect unused pills from local community members. Disposing of leftover painkillers prevents these drugs from falling into the hands of children, teens, and others who meet risk factors for opioid addiction.
Opioid addiction can affect anyone who uses these drugs for any reason. If you need help fighting opioid addiction, call our 24/7 confidential helpline at 866-351-3840(Who Answers?) to discuss all your treatment options with an addiction counselor. We’ll help you find the nearest opioid detox center ready to guide you comfortably and safely through opioid withdrawal and addiction treatment.