Author of The Painful Truth
Prescription medications, by definition, must be prescribed by a doctor. Many people in pain are reporting that doctors are becoming increasingly wary of prescribing opioid medications. This leaves patients in the lurch.
People will often do almost anything to obtain medicines for their pain or to feed their addiction, even if it means buying counterfeit drugs.
To complicate matters, there are several types of counterfeit drugs. All of them are risky, if not deadly, to consume.
When I published my recent blog, Prince and Why We Need More Compassion About Addiction, I began by saying that we didn’t yet know why Prince died. The facts weren’t in, and I didn’t want to draw conclusions until I had more information.
I still don’t have all the facts about the circumstances surrounding Prince’s death. I wasn’t Prince’s physician during his lifetime, and I had no opportunity to look at his medical records either before, or after, his death.
We don’t yet know why Prince died. The facts aren’t in, and I don’t want to draw conclusions until I have more information.
That said, some entertainment media outlets (TMZ, Variety, and more) are reporting that Prince was treated with naloxone, which is the antidote for opioids including heroin, in the days before his death.
If that were true, it would mean that Prince was taking too much of a substance, whether it was prescribed or not.
But, if that turns out to be the case, it won’t change the fact that he was a musical icon, and it won’t change the fact that the world has lost an irreplaceable voice.
Politicians and some government officials tell us that the new CDC opioid guidelines will reduce deaths due to overdoses. But, based on the evidence we’ve seen so far, that is unlikely.
The latest CDC report shows a continual increase in opioid-related overdose deaths despite about a 25% decrease in the number of opioids prescribed. This data demonstrates that an absolute reduction in opioid prescribing hasn’t resulted in the intended outcome–so far, at least. It may be counter-intuitive, but I think you’ll understand why in a moment.
“I remember, the first pain pill they gave me, I felt really good. I actually felt very calm. I felt a sense of confidence that I never felt before. I knew it was going to be the start of something,” said a former high school football star to Soledad O’Brien on an episode of “Real Sports with Bryant Gumbel” called “Hooked” (HBO Sports), that originally aired in February of 2015.
Our wise elders had a saying: moderation is the key to happiness. Unfortunately, there is little moderation where opioids are concerned. They are both over-prescribed and under-prescribed for patients in chronic pain. This results in what I call the opioids paradox.
In fact, opioids sometimes are prescribed in excess. Much, if not most, of the opioid prescriptions (and excess prescriptions) are given in post-trauma situations like ERs, after surgeries for post-op pain, and dentists’ offices; and about 50% of the opioids prescribed after surgeries are never used.
Sometimes, it embarrasses me to be a medical professional. I honor and respect my colleagues, and typically, I’m proud to call myself a physician. But a recent Washington Post story about the enormous biases medical students have regarding pain treatment has troubled me deeply.
The Washington Post story reports that a majority of medical students at the University of Virginia believe that African Americans have less sensitive pain fibers than Caucasians. Of course, that implies that African Americans are not going to feel as much pain as their Caucasian counterparts, which likely leads to differential treatment. Unfortunately, as inexplicable as that finding is, the false belief is not limited to medical students at the University of Virginia.