On March 15th the CDC issued guidelines to address the opioid epidemic which is now two decades or more in the making.
According to the CDC "the United States is in the midst of an epidemic of prescription opioid overdoses. The amount of opioids prescribed and sold in the US quadrupled since 1999, but the overall amount of pain reported by Americans hasn’t changed. This epidemic is devastating American lives, families, and communities."
Also from the CDC:
"More than 40 people die every day from overdoses involving prescription opioids. Since 1999, there have been over 165,000 deaths from overdoses related to prescription opioids. 4.3 million Americans engaged in non-medical use of prescription opioids in the last month."
They summarize their findings by saying that while many American suffer from chronic pain, prescription opioids should only be used short term in most cases. Long term opioid use is associated with serious risks including overdose and opioid use disorder.
This is quite a turnaround from what the government and medical institutions have largely advocated over the past decade or two. When I was a medical student the big focus in my pain management training was on increasing our use of opioid medications and not to be afraid to prescribe these medications. We often got catered drug rep lunchs from various pain medication manufacturers.
In addition, numerous medical and governmental organization board members, who have made recommendations that have resulted in the loosening up of the use of opioids, were receiving generous contributions from opioid manufacturers at the same time.
Just take the example of the American Geriatric Society (AGS). In 2009 the AGS made recommendations that physicians prioritize the use of opioid pain medications for all patients with moderate to severe pain in lieu of traditional anti-inflammatory medications like Ibuprofen. It was later reported that half of the AGS panel experts had financial ties to the drug manufacturers of these medications.
Finally, it is important to put things into perspective. Just take the number of pediatric deaths related to the flu virus. In 2014-2014 there was around 128 flu-related pediatric deaths according to the CDC. It is disturbing that the media and the CDC constantly obsess about getting yearly flu shots while in 3 days prescription opioids kill the same number of people as the number of children that died as a result of the flu all of last flu season. In my mind opioid overdose is also far more preventable than the the flu.
Are there alternatives to opioids? In most cases there are. These includes natural anti-inflammatories like curcumin and traditional NSAIDS. More importantly I believe chronic pain can be largely avoided through a proper anti-inflammatory diet high in vegetables and low in carbs, weight loss, appropriate exercise, proper sleep, and stress/anxiety management.
Of course, each individual case is different and the advice in this post should not substitute for getting a consultation with your doctor.
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