Filling In The Gaps On Pain Prescriptions

Health columnist Judy Foreman

By Judy Foreman
Guest Blogger

Today’s New York times carries a front page article fanning the hysteria – once again – about prescription painkillers.

A prominent number quoted in the article – that, according to the federal Centers for Disease Control and Prevention, 14,800 people died in 2008 in episodes involving these painkillers – is correct. And that’s 14,800 too many. No doubt about it.

But look at what the article failed to say: That, again according to the CDC, half of all those deaths involving prescription painkillers also involved at least one other drug, including benzodiazepines, cocaine and heroin. And that “alcohol is also involved in many overdose deaths.” To blame it all on prescription painkillers – and pain patients and their doctors – is simply not the full truth.

 

The New York Times story also failed to note that, in contrast to the 14,800 people whose deaths involved prescription painkillers, 443,000 American adults die every year from cigarette smoking. And more than 80,000 die every year from excessive alcohol use. Non-prescription painkillers such as NSAIDS (non-steroidal anti-inflammatory drugs like ibuprofen) aren’t exactly benign, either – they kill an estimated 7,000 to 10,000 American adults a year.

Nor did the article mention the extent of suffering caused in this country by chronic pain.
According to a recent report from the Institute of Medicine, an estimated 100 million Americans live in chronic pain, and that doesn’t count children, people in the military or in institutions such as nursing homes.

And – estimates vary – one tenth to one third of them have chronic pain that is severe and disabling. At least some of this latter group do need opioids, probably strong ones, and possibly for the rest of their lives. To put too many barriers in the way of access to opioids is tantamount to what some ethicists call “torture by omission.”

Furthermore, the New York Times articles picks on doctors for overprescribing painkillers. But doctors are not the real problem.

If it’s diversion and abuse that you’re worried about, consider where street abusers actually get their drugs. According to a 2009 government report, 53.3 percent get their drugs free from a friend or relative, 9.9 percent buy them from a friend or relative, 5 percent steal them from a friend or relative. That’s roughly 70 percent who get it from your medicine cabinet and mine. (And yes, 17.6 percent get them from a doctor.)

To be sure, opioids are not perfect painkillers. In fact, by some estimates, they’re only 30 to 40 percent effective. And yes, of course, non-pharmacological treatments are essential (though not always reimbursed) for treating chronic pain, including meditation, exercise, distraction, acupuncture and massage.

Prescription painkiller deaths grab the headlines, and the front page stories. But all too often, the silent suffering of people in chronic pain does not.

Judy Foreman, perhaps the best-known health reporter in Boston and a nationally syndicated columnist, is writing a book about chronic pain titled “A Nation in Pain: Healing Our Biggest Health Problem.” 

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  • http://www.facebook.com/Rhonda36 Rhonda Delgado

    Thank you!! I’m really tired of being made to feel like a crack head when my home pain meds are not working and it requires a trip to the ER just to be able to not scare my 4 and 6 year old with my constant screaming and realing in pain.

  • Jennb620

    My sincere gratitude for a article well written without false facts & ALL statistics mentioned! !

    Sincerely,
    Jennifer Bernhard
    (Chronic pain suffer since 2008, palm harbor, FL)

  • http://www.facebook.com/people/Donna-Ratliff/100001049442494 Donna Ratliff

    Thank you Judy for clairifying that media articles are hyper inflated!! I am an advocate for chronic pain patients. I am a Florida leader for the American Pain Foundation and I will tell you that many people feel that their civil and human rights are being violated especially here in Florida. Our pharmacies are denying our us our legal and legitimate prescriptions. Our doctor are in fear to treat pain properly.http://www.change.org/petitions/florida-pharmacies-stop-florida-pharmacies-from-denying-pain-patients-vital-medicinesWe created this petiton to prove what is really going on here.We also updated with another one.
    http://signon.org/sign/pain-patients-are-suffering-1This problem is not fair to legitimate pain patients anywhere in the country and we wanting everyone to sign and share our petitions. We are FIGHTING back!! Pain patients have a right to timely, effective pain care. Feel free to conatct me. I would to help advocate with you.,

    Sincerely, Donna Ratliff

    • Junkies Ruined Everything

      I Would Hate 2 Be A Patient In Florida Right Now ! Florida Was The #1 Place In America Feeding The Fire With The Massive Amount Of Pain Clinics Popping Up And People Traveling From All Over The Country To ABUSE The Previous Laws  Pertaining To The Lack Of Controlling These Potentially High Risk For Abuse Opiate Medications.The Pill Mills With Inside Pharmacies Were A Open Invitation For Every Junkie In America!!These People Were Receiving Massive Quantities Of Opiates & Dr, Shopping Seeing Up To 5 Different Dr`s At Several Different Pain Clinics In A 2 Week Period.This Type Of Activity Has Taken Which Once Was The Sole Focus Of Opiates 2 Treat Chronic Pain To All Focus Being Shifted Soley To The Junkies Abusing Them.This Is What They Are Catering 2 While The Chronic Pain Patient Is Paying The Cost`s!!They Have Gone As Far As Reformulating Most Opiates Rendering Them Up To 90% Less Effective Just 2 Stop These Retards From Sticking Pills In Their Arms!A Chronic Pain Patient Should Not EVER Be Placed In The Same Caterogory As These Pieces Of Dirt ! To Top Things Off They Get Synpathy For Being Junkies While We The People In Chronic Pain As The Article So Well Put “Suffer In Silence”! Since We Are Not Out Robbing People And Breaking Into Peoples Houses & Ruining Everybody Elses Life Around Us We Are Payed No Mind.Junkies Just Sicken Me To No End & I Have No Sympathy For People Who Have Selfishly Have Managed To Create This Situation For Us.They Don`t Care About Us!!

    • Dtkruger

      Ok so im a new yorker in chronic pain since 2001, so my pcp finally broke the dreaded PM specialist talk, now common sense ………. why wouldnt you (MY PCP) inform me WEEKS before of her ” new policy” . Adding insult to injury the new doctor was extremely rude ………. stigma syndrome is what my latest ailment is! Please help me help myself and others in the new york Area re: Governer Cuomo`s legislative bill. The only way i can maintain daily living is with a caring non bullied doctor, so i can work on the rest of my education and eventually be able to hold a job,not call in sick, or rely on disability benifits………..they dont get chronic pain…….the recent arrests were necessary, but those of us in our condition should never go through this type of scrutiny, and the best is STOPPING suddenly would be a greater risk then weaning a patient, anything happens to me physically hugh and they violate their hypcratic oath “To Do No Harm”, do you think the medical profession will not be sued? And it should be a class action one at that! Clearly they havent thought this through.

    • Katharine

      Dear Donna, I’ve been suffering from Interstitial Cystitis for 8 years and I am stuck with a pain doc that tells at me and is super rude. He won’t discuss pain treatment unless you agree to nerve blocks. Hello, IC patients need to be able to feel if they might have a bladder infection. I moved to OH 8 month ago and. Any find a doctor that is not too scared to treat my pain. This is so unfair!!! I’d there anything I can do to fight back?
      Thanks,

      • Deb

        Hi Donna,
        I live in Florida and was diagnosed with ic as well. I was crying in the phone with my MD’s nurse yesterday telling her that I need some form of pain relief. The doctor called me back last night to give me an anti inflammatory drug and won’t perscribe pain killers because ” she scared I will become addicted.” Really! I feel like I have acid in my lower body and you’re worried that i will become addicted if you give me a rx! I am a person who believes in eastern and western med. I have been sipping down aloe juice and stopped eating everything that would couse a flare up. I don’t know what to do.:(

  • jeanne

    If you are a legitimate pain patient who is having difficulties there is a small grassroots group who is trying to fight back.   https://www.facebook.com/FightForPainCareActionNetwork

    • http://www.facebook.com/people/Donna-Ratliff/100001049442494 Donna Ratliff

      The page listed above is my facebook Page to bring awareness to our problems. I also have a support group on facebook as well for Florida patients that need support and help in advocating.

  • jeanne

    Thank you for writing this.  i am a chronic pain sufferer too.  I want to write a more intelligent post but as I am under-medicated for my pain i cannot right now.  but, thank you so much for writing this.  more needs to be written about the struggle that people in pain go through in their vain attempt to have their pain relieved.  i will write again when and if i can.

  • Anonymous

    Doctors are the real problem as they refuse to have any education in pain care.  70% of physicians fail basic test of musculoskeletal knowledge- 80% of pain is musculoskeletal. In another study done last year 25% of nurses blamed physician lack of caring for poor pain care. In a study publshed this month 70% of physicians who prescribe opioids said they dont feel educated enough in opioid use. The wilfull neglect of people in pain by medicine is well documented-its unfortunate that Ms Foreman is biased in her assessment of the source of the problem. Until we require physicians to obtain needed technical and nontechnical skills to address peoples pain the crises will only worsen and the dried voices of people in pain will remain mute and meaningless and as distant as fading stars to doctors.

    • Junkies Ruined Everything

      Anybody Who DOES Have Knwoledge On The Matter Without A Doubt  KNOW It Is The JUNKIES That Have Ran To Every DR Around Trying To Get Pills Because They “HURT EVERYWHERE” & On A Scale Of 1-10 It`s Of Course A 10!.Their Lies Have Created This Enviroment Where Dr`s Are So Hesistant To Prescribe Because These Junkies Instead Of Going To A Rehab Or Enter A Methadone/Suboxone Place , Are Filling Up These Dr Offices To The Point Someone In Legit Pain Can Not Even Get A Appointment! It Would Discourage Dr`s After Dealing With Those Dirty Scumballs Every Damn Day !

  • Jen

    THANK YOU!
    Jen, chronic pain sufferer, Cincinnati, OH

  • Matia Spicer

    I am so sick of reading about pain medicine abuse!!!! I need pain medicines for my REAL disease that are incurable and extremely painful.  Pain medicines allow me to live a somewhat normal life that would not be afforded to me otherwise. I’m sick of the stigma that money hungry doctors and people with addictions are passing on to me because I happen to be a person who has a life that includes narcotics.  Narcotic use is actually encouraged with the diseases I have because they are safer, and easier on my organs than over the counter pain medicines.  Why do we hear so little about the dangerous side effects they have on the body? Enough already!!