The Deadly Trap of Opioid Painkillers

In the Democratic debate one of the questions dealt with the epidemic of heroin overdoses that has hit the country in recent years. But it's not just heroin: a lot of it is other opioids such as OxyContin and Vicodin and Percocet. Heroin use is way up because people addicted to those prescription drugs turn to street when their pusher doctor stops handing out scrips like candy.

Last year more than 47,000 people died of drug overdose; almost 30,000 of those deaths were from opioids -- as many people as were killed by guns and car accidents. The three candidates in the debate all agreed that more has to be done to prevent doctors from overprescribing addictive drugs. But it's not just doctors: patients have to stop asking for them.

And doctors do hand these drugs out like candy. About 10 years ago I came down with pneumonia. I didn't even know I had it -- I just had a terrible headache and couldn't sleep, but had no congestion or even a cough. After a false start with the wrong antibiotic, they finally gave me the right stuff -- Zithromax -- and without my asking for it, a prescription for Percocet.

I don't generally bother with drugs to treat headaches -- they never work anyway. But I hadn't slept for days, so I took the antibiotic and one tablet of Percocet. However, as soon as I started to drift asleep I stopped breathing: I'd overdosed on a single pill. So now I had to force myself to stay awake and concentrate on each breath, and the headache was still killing me. Fortunately the Zithromax worked almost immediately and I was better the next day.

And it's just getting worse: every time I or my wife have even the most minor surgery, the doctors are always eager to push some more Vicodin or OxyContin on us.

My system is probably hypersensitive to the effects of opioids, but these drugs -- Percocet, OxyContin and Vicodin -- are inherently dangerous. The difference between a useful therapeutic dose and an overdose is fairly small. People who rely on them to alleviate severe pain for years on end build up an addiction and a tolerance to opioids. They have to take larger and larger doses, inching over the years toward an eventual deadly overdose.

When their doctors finally cut them off they turn to the street to buy prescription meds illegally, like Rush Limbaugh did, or they buy heroin. The quality of street drugs is extremely uneven, increasing the likelihood of an overdose.

The CDC has now recognized opioid overdoses as an epidemic, and has been working to revamp the guidelines for prescribing these drugs. But drug companies are fighting this tooth and nail. CDC has now delayed a plan to issue new guidelines. Big Pharma doesn't want their opioid cash cow gored.

People who have severe pain feel they have no alternative but to take drugs. But opioids like oxycodone were originally intended as a temporary stopgap for cancer patients; people in acute pain who were either being cured of their disease or dying from it. These drugs were not intended to be taken for years on end for chronic pain from mundane conditions such as ruptured discs or diabetic nerve damage.

Now, I'm not saying that people plagued by severe back pain should just suffer. But painkillers can only ameliorate pain temporarily -- they cure absolutely nothing. If patients have severe neuropathy, the goal should be to remedy the underlying physical condition. Not dope them into a stupor for the rest of their lives.

Real cures require expensive and/or risky surgery, or extensive changes in behavior or ongoing physical therapy and exercise. Health insurance companies don't like the former and patients don't like the latter. And in some cases we don't have any viable cures yet.

So the cheap, easy and lazy thing to do is hand out painkillers as if they were M&Ms.

Taking painkillers will never fix what's really wrong when people suffer from pain. But drug companies like that. They have no incentive to find real cures for the underlying causes of chronic pain, because their business model depends on hooking more and more people on opioids and milking their pain for the rest of their lives. Just like any pusher on the street.

Martin Shkreli, the former CEO of Turing Pharmaceuticals who was recently arrested for securities fraud, became infamous for jacking up the price of a sixty-year-old life-saving drug by 5,000 percent, from $13.50 to $750 dollars per pill. He saw nothing wrong with telling AIDS patients and mothers of sick newborns, "Your money or your life!"

Shkreli is a disgusting imitation of a human being, but at least he was being honest. The CEOs of drug companies hawking opioids are doing the same thing, saying, "Pay us or suffer the fires of hell for the rest of your miserable life!"

This is the problem when capitalism intersects with medicine. Corporations, as Shkreli told us, aren't in the business of making people healthy. They're solely in the business of making money. More money. More quickly.

Americans should stop putting up with expensive, half-assed solutions to medical problems: painkillers are not the answer to chronic pain. The medical-industrial complex is making trillions of dollars off our suffering.

We should be getting real cures for all the money we're spending. Not a temporary fix that addicts us to dangerous drugs that will eventually kill us.