Painkiller abuse needs attention, too
About five years ago, I broke my wrist and I was in a lot of pain.
I was given a prescription for the powerful narcotic painkiller Hydrocodone and told that I could refill it if my pain persisted. I tend to react poorly to painkillers, and Hydrocodone was no exception. It made me vomit and also made me feel like a heavy fog had settled on my brain.
“How do people become addicted to this awful stuff?” I remember thinking, during one of my rare lucid moments.
Of course, the Hydrocodone also took my pain away and caused me to fall into deep, dreamless slumbers. It provided an amazing amount of relief, and by the end of my two-week supply I had gained some insight into how someone might become addicted to it.
I thought of my mind-altering Hydrocodone experience earlier this week when I read about the troubling resurgence of heroin in the Capital Region. Experts say the jump in heroin use is linked to the abuse of prescription painkillers that fall into the opioid category, such as Hydrocodone and Oxycodone.
According to a recent article in The Journal of the American Medical Association, nearly 80 percent of people who began using heroin in the past year say that they previously abused prescription painkillers. Dr. Michael Dailey, an emergency room physician at Albany Medical Center, told the Sunday Gazette that people are turning to heroin because it’s cheaper and often easier to obtain than prescription painkillers.
“The economics of heroin seem pretty simple,” Dailey said. “It’s dropped in cost, the cost of pills have gone up in cost and the access to pills has gone down.”
What seems clear to me is that any effort to address the area’s growing heroin problem should include a discussion of opioid painkillers. These drugs might be legal, but they can also be highly addictive — and lethal.
According to the Centers for Disease Control, overdoses of prescription painkillers have more than tripled in the past 20 years, killing more than 15,500 people in the United States in 2009. That year, about 12 million Americans reported using prescription painkillers for nonmedical reasons such as getting high.
“Overdose deaths have skyrocketed in the past decade, largely because of prescription painkillers,” a CDC paper from November explains. “The stories are tragic: A father whose addiction to prescription painkillers ended in a fatal overdose. A teen who died after taking prescription painkillers stolen from a friend’s grandmother. Nine members of one small community who overdosed on painkillers they got from pain clinics.
“Enough prescription painkillers were prescribed in 2010 to medicate every American around the clock for one month,” the CDC paper says.
What’s driving this? Are Americans in more pain than they used to be? Are too many doctors writing prescriptions for painkillers without considering alternatives, or adequately warning their patients about risk?
Earlier this year, I wrote a story about the relatively new pain management center at St. Mary’s Healthcare in Amsterdam. The goal of the clinic is to help patients manage chronic pain, but also to reduce their dependence on opioids. The director of the clinic, Dr. Jason Steindler, told me he recommends a variety of treatments, from surgery to medication (anti-seizure drugs and antidepressants are both known to reduce pain) to acupuncture to yoga.
“People were not meant to be on high-dose opioids for life,” Steindler told me. He also said that most people aren’t aware of the side effects of prescription painkillers. “I make it my job to educate them,” he said.
I don’t want to downplay the dangers of heroin.
I was as disturbed as anybody by the story of the 17-year-old Shenendehowa student who was arrested for allegedly injecting a 15-year-old student with a liquid form of the drug. Certainly we don’t want teenagers abusing heroin. Or anybody else, for that matter. And we should make sure treatment is available to those who need it.
But we should keep things in perspective. Heroin sounds scarier than prescription painkillers, which might explain why it was the subject of a legislative forum last week. But the statistics suggests that prescription painkillers do more damage.
A friend of mine recently cut his hand on a circular saw and went to Ellis Medicine for stitches. Afterward, he expressed disbelief that they wouldn’t prescribe him a painkiller. “I’m in pain!” he said.
“Take some Advil,” I said. “You’ll be fine.”
Now, some people really need prescription painkillers.
But a lot of people — including my friend — do not.
Sara Foss, a Gazette columnist, can be reached at email@example.com. Opinions expressed here are her own and not necessarily the newspaper’s. Her blog is at www.dailygazette.com/weblogs/foss.