The horrifying dimensions of the crisis loomed over an FDA hearing this week where chronic pain advocates and patients warned that focusing on prescription drugs will add unnecessary suffering to the death toll.
As summarized by Science Daily, the St. Michael’s study found “the percentage of deaths attributable to opioids in the U.S. increased by 292 percent from 2001 to 2016, with one in every 65 deaths related to opioid use by 2016.” Almost 70 percent of the dead were male.
Factoring in the youth of the victims, the authors calculated that “1,681,359 years of life were lost prematurely to opioid-related causes in 2016, which exceeds the years of life lost each year from hypertension, HIV/AIDS, and pneumonia in the U.S.”
The Food and Drug Administration held a hearing on Monday at which chronic pain advocates expressed concerns that people who truly need painkillers aren’t getting them because the stampede to Do Something about the opioid crisis is mistakenly targeting prescription drugs.
“We are sick with devastating pain conditions yet doctors will no longer treat us. We have been forced off opioid medications we have used appropriately that have helped us to function. We are suffering to the point that many of us are losing the will to live. Why don’t you hear our pleas and take action to stop this inhumane treatment?” asked Cindy Steinberg of the U.S. Pain Foundation.
USA Today saw the FDA hearing as a hopeful sign that the federal government is considering input from chronic pain patients and is beginning to understand how ham-fisted controls on prescription drugs are causing more harm than good.
One remarkable fact disclosed in the article was that the Centers for Disease Control re-evaluated its methodology in April and discovered its estimate of Americans killed by prescription drug overdoses was almost 100 percent too high – 32,445 estimated for 2016 vs. a revised total of 17,087. A good deal of public policy is driven by such estimates.
For example, USA Today quotes Florida House Speaker Richard Corcoran’s defense of tough regulations on prescription opioids in his state: “Is that an inconvenience? Yes. Is an inconvenience worth saving 50,000 lives nationwide? Absolutely.” But what if it’s not saving 50,000 lives nationwide?
Among the “inconveniences” Corcoran referred to are restrictions on how many pills a patient can obtain at one time, a strategy UPI reported has been adopted by private-sector insurance companies and pharmacies even though “legitimate patients have been caught up in the well-meaning efforts”:
Last year, CVS announced it will limit all opioid prescriptions to a seven-day supply, becoming the first major retail chain to do so in the wake of the opioid epidemic.
In May, Walmart announced it will limit prescription painkillers also to no more than a seven-day supply.
Cigna, the fifth-largest medical insurance provider in the United States, announced in March it has reduced opioid use by 25 percent among its members. In 2016, the company said it would start capping prescriptions for short-acting opioids for acute pain to 15 days and plans to further limit prescriptions to seven days.
Cigna also said it would start removing OxyContin from group commercial drug lists, but not other painkillers that contain oxycodone, the active ingredient in OxyContin.
UPI added that President Donald Trump has considered “suing drug companies and punishing some drug dealers with the death penalty,” an alpha-omega mix of policies that neatly encapsulates the fears of pain patients and their doctors. Suing drug companies is easy and lucrative. Punishing drug dealers and interdicting the flow of drugs across the border is hard. Guess which option the political elite prefers?
The New York Times looked at the river of opioid legislation flowing through Congress in June and found over 50 bills related to the epidemic – a mixture of everything from funding for new studies to prescription drug policies and crackdowns on crime. Legislators wish to be seen as fully engaged with the deadly epidemic, especially those up for re-election in November. Partisan organizations seek to spotlight the work done by vulnerable members of the parties they support. Few legislators relish the consequences of voting against anything related to opioids.
Many of the proposals deal with expanded access to addiction treatment, research into non-addictive painkillers, and measures to combat the abuse of prescription drugs. And yet, as the Times noted, “prescriptions for opioids have been falling since 2012” even as “the overdose death toll has continued to rise.” Street addicts are reluctant to seek addiction treatment, they’re not abusing prescriptions, and they won’t be terribly interested in the non-addictive painkillers of the future.
Last week, Stat News reviewed social media posts from cancer patients and caregivers to bring attention to the vastly underestimated and under-reported under-prescription crisis caused by regulations and policies that keep drugs from people who desperately need them:
Some writers said their doctors now hesitate to prescribe opioids due to concerns over addiction. Restrictions on refills and their timing are barriers to consistent use of medications to treat pain. Many of the writers said they felt they were being treated like drug seekers when their pain needs are real and management is necessary. Their experiences with access were described as: “makes me feel like a druggie,” “I use a very low dose,” “treated like a pill seeker,” and “I am not part of the oxycodone EPIDEMIC.”
One individual wrote, “I have been made to feel like a criminal – from my doctor’s office…to the pharmacy worker who said very loudly to other patients in line that I was sure taking a lot of opioids. I was humiliated. I have been afraid to ask for pain relief as it seems like I am doing something wrong. During my cancer journey, I had to have a hysterectomy without pain relief…Hospitals feel they are opening the door to opiate abuses and my surgeon would not authorize pain medicine. I am terrified right now to ask for a refill on my pain medication.”
The correspondence reviewed by Stat News suggested that many people suffering from chronic pain are afraid to take the medication they have been given, fearing they will become addicted, or make do without their pills because media coverage of the opioid epidemic makes them feel guilty.
Critics of the opioid war fear that politicians are fighting the last battle: acting harshly against prescription medications in a delayed response to a problem that was much more severe ten or twenty years ago before the crisis transitioned away from abuse of prescription medications to street drugs. Heavy reliance upon old and debunked statistics by bureaucrats and the media feeds these fears.
The ultimate nightmare is that bureaucrats and politicians don’t want to study the real causes of the opioid crisis carefully, because they’re afraid of what they will find. Daniel Horowitz at Conservative Review zeroed in on an overlooked statistic from reports of the opioid death toll, such as the one published by St. Michael’s in Toronto: why are the dead overwhelmingly young and male, when the population of chronic pain patients skews older and female?
The logical answer, according to Horowitz, is that we are actually facing a massive problem with “illicit drugs – both opioids like heroin and non-opioids like cocaine and meth – brought in by open-border policies” to meet a drug demand stemming from “emotional and mental well-being and cultural problems, not from pain treatment.”
“In order to cover for the dual agenda of open borders and de-incarceration of drug traffickers, the government is now hurting pain patients who have never been prone to addiction. This is the true opioid crisis that deserves Congress’ attention. Opioids are already under strict control, hampering doctors and patients. Now is the time to focus more on the border and criminal alien distribution networks, not doctors and pain patients,” Horowitz contended.