Just a couple of years ago, the term “opioid” was still unfamiliar to many. Now, paired with the word “crisis,” it’s a household phrase.
The problem is real, no doubt. And, it’s been more than three decades in the making. Most agree it began in the late 1990s, when public attention was drawn to the plight of chronic-pain sufferers. A wave of public and political pressure, augmented by Big Pharma’s lust for sales, led to the creation and widespread prescription of new and old pain drugs, and fresh ways to deliver them by extended release.
In 2001, by the time Congress announced the inauguration of the “Decade of Pain Control and Research,” things were already going downhill fast. From 1999 to 2010, the number of opioid prescriptions skyrocketed and, according to the Centers for Disease Control and Prevention, the amount of prescription painkiller overdose deaths nationwide rose fivefold in women, 265 percent in men.
In the last few years, America’s opioid epidemic hasn’t ended, as many different forces have been at play. And, despite the widespread attention the problem has gotten, the addiction and death continue. According to a January report by the National Institute on Drug Abuse, “Every day, more than 130 people in the United States die after overdosing on opioids, both legal and illegal.”
Those who’ve succumbed are just the tip of the iceberg, with many victims at different levels of a highly complex set of problems. In some cases, politics has hamstrung key decision makers and created different kinds of human harm, keeping opioids from many who genuinely need them.
While political, regulatory and even legal pressures have combined to control opioid prescriptions, the problem persists. New laws and rigorous regulations track and limit prescriptions. While fewer overdoses of prescription opioids have occurred nationally in the last few years, deaths from nonprescribed and illegal opioid overdoses have increased.
The result has led to what some call a second opioid crisis. The victims are people with chronic pain, even cancer, whose doctors are unable or unwilling, because of regulation or perceived pressure, to prescribe the legal medicines to manage their agony.
As the population ages, more people are suffering from chronic pain, much of it simply the result of wear and tear and aging. Many of the folks who have had surgery for their backs or knees, or a hip replacement, still experience crippling pain.
Nonpharmaceutical pain management offers answers to some. There are many alternatives, from physical therapy and yoga to back surgery, platelet-rich plasma injection, high-intensity laser treatment and the widening field of stem-cell therapy. Yet, for many older or poorer patients, or those in rural areas, access to pain-management clinics is limited.
It seems important to remember that legal opioids are a practical and positive answer to suffering for some, and that many responsible doctors can distinguish addictive patients from those the drugs actually help.
After a year of planning, work and raising grants, an expert task force comprised of local, medical and public health experts is launching a Bexar County Opioid Prevention and Intervention Program. Its goals are good ones, from preventing overdoses through wider distribution of antidote drugs to educating people and physicians about addiction, and increasing treatment options. Handicapping doctors and penalizing chronic-pain patients is a backlash, not a solution.