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Wednesday, 4 April 2018

Opioid Addiction. The disastrous failure of painkilling drugs

Opioid Addiction in the USA if rife, and there are concerns that a similar situation may arise in Britain, and other countries where conventional medicine, with its reliance on painkillers, dominates health care. The addiction kills - drug overdose, arising from addiction, is now a leading cause of 'accidental' death.

Opioids drugs are made from opium, and 'work' by stimulating the brain's opiate receptors. In other words, they trigger 'pleasure receptors' in the brain, which makes them drugs to which people can easily become addicted, and in time requiring more powerful drugs as the body begins to tolerate them.

In the US alone, 42,000 people have died from opioid addiction, and another 2.1 million became addicts, in 2016. Opioid drugs are prescribed by conventional medical doctors under names such as hydrocodone, oxycodone, buprenorphine, with more commonly as fentanyl, codeine, morphine, and tramadol.

Conventional medicine is dependent on these opioid drugs in palliative care, after major surgery, and serious accidents. But they are also used frequently for more common conditions - as painkillers for back pain and similar.

The problem for doctors is that whilst they might know how dangerous they are, they have nothing safer to prescribe They know that they should not be used on a long-term basis (for any more than a few days) but they do. Faced with a patient in chronic pain, when there is nothing else in their medicine cupboard, doctors feel obliged to prescribe them. Other painkilling drugs, like NSAIDs, are not so 'effective' in killing pain, and in any case they too come with serious side effects that patients are not told about. So doctors continue to prescribe them, and patients become addicted to them. Or alternatively, doctor's refuse to prescribe them and addicted patients go on to obtain heroin, illegally, on the black market.

Opioid prescription has soared in recent decades, and alongside this the rates of addiction and death by overdose have increased proportionately. The statistics coming out of the USA are devastating.  Overdose deaths caused by painkillers have risen by more than 300% since 1999, and it is estimated that more than 12 million Americans used prescription drugs for 'non-medical' reasons in 2010. In just three years, deaths from opioid drugs have risen from 3,000 to over 20,000 in just three years, and this carnage is expected to continue, devastating the lives of huge numbers of people and their families.

Whilst doctors have little else to offer, and in any case most of them are too busy attacking alternative medical therapies to find safer and more effective treatment, the evidence is that pharmaceutical companies have not only profited from selling them, but promoted them aggressively. They said that the addictive properties of opioid drugs were not really as bad as believed, so they could be used more widely, and for longer periods.

In other words, Big Pharma used their normal marketing strategy - minimising the risks of their drugs addiction - and exaggerating their benefits.

So we have the rather strange situation of a society that bemoans the use of 'illegal' drugs, and the human devastation caused, but allows drug companies to advertise, promote and profit from 'legal' drugs that are indistinguishable from them! Drug pushers who do not have a conventional  medical qualification are pursued and prosecuted, but pharmaceutical companies are allowed to push similar drugs because they are used for 'medical' purposes. The outcome of both is human tragedy.

Yet perhaps the tide is turning, there are now moves to prosecute the pharmaceutical pushers. One Natural News article states that "Settlement talks have begun in opioid lawsuits against Big Pharma with over 250 cases have been brought against multiple companies". This would certainly be well deserved, but the drug companies will probably pay their way out of this legal crisis - they usually do. We will see.

The conventional medical establishment is aware of the problem. An article in The Lancet, 24 February 2018, outlines the seriousness of the situation. Yet there is no proportionate response forthcoming. If road deaths, and accidents at work, were killing as many people as opioid drugs (as well as other pharmaceutical drugs and vaccines) health and safety measures would swing into effect. Decisive action would be expected, demanded, and the public authorities would be obliged to respond. But not in health, not if it affects the pharmaceutical industry. The Lancet article does not ask for action, there has been no call to ban these drugs, just their more responsible prescribing behaviour by doctors.

If the precautionary principle were to be applied to this situation pharmaceutical drugs would be immediately banned.

So will the USA opioid crisis be exported to Britain? The MIMS magazine clearly thinks so, in its article "Long-term opioid prescribing increasing despite questionable efficacy", which states that opioid prescribing in England increased from 2010 to 2014 despite these drugs have been shown, in a study published by the British Journal of General Practice, to be "ineffective in the treatment of chronic non-cancer pain". So the devastation caused by opioid drugs continues - even though doctors have been told that the drugs are of 'questionable efficacy'.

Patient Harm without any corresponding Patient Benefit!

Yet there is worse. Pharmaceutical companies have actually been paying (bribing) doctors to prescribe opioid drugs. This was reported by CNN, a USA news agency that is usually very friendly towards conventional medicine. Alongside Harvard University they found that opioid manufacturers, the drug companies, have been paying doctors huge sums of money to prescribe the drugs, and the more opioids a doctor prescribed, the more money he or she makes!

               "In 2014 and 2015, opioid manufacturers paid hundreds of doctors across the country six-figure sums for speaking, consulting and other services. Thousands of other doctors were paid over $25,000 during that time. Physicians who prescribed particularly large amounts of the drugs were the most likely to get paid."

In a What Doctors Don't Tell You (WDDTY) article another suggestion is made, that the opioid epidemic has been fuelled by doctors "who have forgotten just how many prescriptions they have written out to patients"! It states that around 65% of doctors working in hospital emergency units are under-estimating the number of prescriptions they are writing, that emergency unit doctors write up to 10% of all opioid prescriptions, and researchers think a similar under-estimation could be seen among other doctors as well. These findings cam from a year-long survey whose lead researcher is quoted as say that
               "Most believe they are doing the right thing, but we need to directly address this thinking to be sure they are not part of the problem"

So we are left with a conundrum. 
Do doctors know what they are doing and get paid for doing it? Or are they just rather forgetful? 

Either way, as usual, it is the patient who submits to conventional medicine who suffers!