Deaths caused by overdosing on painkillers now surpass murders and fatal car accidents in the US. America's rising drug problem recently received renewed attention following the death of Philip Seymour Hoffman.1 The 46-year-old Oscar-winning actor died from a heroin overdose on February 2. Last year, Hoffman entered rehab when addiction to prescription painkillers led him to switch to heroin. US officials now acknowledge that narcotic painkillers are in fact a driving force in the rise of substance abuse and lethal overdoses. Over the past five years alone, heroin deaths have increased by 45 percent2--an increase that officials blame on the rise of addictive prescription drugs such as Vicodin, OxyContin, Percocet, codeine, and Fentora, all of which are opioids. The reason for the resurgence of heroin is in large part due to it being less expensive than its prescription counterparts. According to Gil Kerlikowske, director of the U.S. Office of National Drug Control Policy:3 "The use of opioids -- a group of drugs that includes heroin and prescription painkillers -- is having a devastating impact on public health and safety in communities across the nation. In 2010, approximately 100 Americans died from overdoses every day. Prescription painkillers were involved in more than 16,600 deaths that year, and heroin was involved in about 3,000 deaths."
"The use of opioids -- a group of drugs that includes heroin and prescription painkillers -- is having a devastating impact on public health and safety in communities across the nation.
In 2010, approximately 100 Americans died from overdoses every day. Prescription painkillers were involved in more than 16,600 deaths that year, and heroin was involved in about 3,000 deaths."
Many are still under the illusion that prescription drugs are somehow safer than street drugs, but it's important to realize that prescription medications like hydrocodone and oxycodone are opioids—just like heroin. As explained by Dr. Wilson Compton,4 deputy director of the US National Institute on Drug Abuse, heroin, morphine, hydrocodone, and oxycodone "are all classified as opioids because they exert their effect by attaching to the opioid receptor found in our brain and spinal cord." They also create a temporary feeling of euphoria, followed by dysphoria, which can easily lead to addiction. Some people end up taking increasingly larger doses in order to regain the euphoric effect, or escape the unhappiness caused by withdrawal. Others find they need to continue taking the drugs not only to reduce withdrawal symptoms but to simply feel normal. Opioids also depress your heart rate and breathing. Large doses can cause sedation and slowed breathing to the point that breathing stops altogether, resulting in death.5 According to a 2013 US Substance Abuse and Mental Health Services Administration report, nearly 80 percent of people who recently started using heroin had previously used prescription painkillers. As reported by WebMD:6 "To break this link, the federal government has begun to crack down on 'pill mills' and doctors who over-prescribe narcotic painkillers. It has also developed education programs for doctors and patients on prescribing painkillers and disposing of unused prescriptions."
"To break this link, the federal government has begun to crack down on 'pill mills' and doctors who over-prescribe narcotic painkillers. It has also developed education programs for doctors and patients on prescribing painkillers and disposing of unused prescriptions."
Do you ever occasionally wonder about the fantastic lack of common sense among prescribing physicians? According to one recent study,7 more than 14 percent of pregnant women were prescribed opioid drugs during their pregnancy. The paper called for more research to assess the risks to the fetus, in light of such surprisingly high prescription rates. But truly, knowing the risks involved in adults, how could anyone in their right mind imagine the risks to an unborn child might be anything but harmful? Back pain—a problem most pregnant women have to deal with—was the most commonly cited reason for the prescription. Narcotics were also prescribed for complaints of abdominal pains, migraine, joint pains, and fibromyalgia. As reported by Medical News Today:8 "The study looked at data from a research database of more than 530,000 pregnant women enrolled in a commercial insurance plan who delivered their babies between 2005 and 2011. Their median age was 31... Of the more than 530,000 pregnant women, 76,742, or 14.4 percent, were prescribed opioids at some point in their pregnancy... [A] US National Birth Defects Prevention Study (1997-2005) found associations between codeine and other opioids with birth defects, including atrial and ventricular septal defects, hypoplastic left heart syndrome, spina bifida, and gastroschisis in newborns. Additionally, the US national study cites that when opioids are used long-term during pregnancy, 'there is a known risk for neonatal opioid dependence and subsequent withdrawal symptoms in the first few days of life.'"
"The study looked at data from a research database of more than 530,000 pregnant women enrolled in a commercial insurance plan who delivered their babies between 2005 and 2011. Their median age was 31... Of the more than 530,000 pregnant women, 76,742, or 14.4 percent, were prescribed opioids at some point in their pregnancy...
[A] US National Birth Defects Prevention Study (1997-2005) found associations between codeine and other opioids with birth defects, including atrial and ventricular septal defects, hypoplastic left heart syndrome, spina bifida, and gastroschisis in newborns. Additionally, the US national study cites that when opioids are used long-term during pregnancy, 'there is a known risk for neonatal opioid dependence and subsequent withdrawal symptoms in the first few days of life.'"
The US Food and Drug Administration (FDA) recently recommended tighter controls on painkiller prescriptions,9, 10 and has announced its intention to reclassify hydrocodone-containing painkillers from a Schedule III to a Schedule II drug. The drug schedule system classifies medications based on their potential for abuse and addiction, as well as other medical criteria. The reclassification will affect how hydrocodone-containing drugs can be prescribed and refilled. Doctors will only be allowed to prescribe a 90-day supply of the drug per prescription, and they will no longer be permitted to phone in refills; rather the patient has to bring the prescription with them to the pharmacy. The new regulations are expected to take effect sometime this year. Ironically enough, while talking about the need for stricter controls and less addictive painkillers, it recently approved the first drug containing pure hydrocodone for the US market, called Zohydro ER (Zogenix). All other hydrocodone-containing painkillers on the market are mixed with other non-addictive ingredients. Zohydro ER was approved for patients who need around-the-clock pain relief. As reported by Bloomberg at the end of October last year:11 "The approval came as a surprise since an FDA panel of outside advisers gave the drug an overwhelmingly negative review last year. The panel of pain specialists voted 11-2, with one abstention, against approving the drug. It questioned the need for a new form of one of most widely-abused prescription drugs in the United States. The approval also came a day after the FDA said it would support stronger restrictions on combination drugs containing hydrocodone."
"The approval came as a surprise since an FDA panel of outside advisers gave the drug an overwhelmingly negative review last year. The panel of pain specialists voted 11-2, with one abstention, against approving the drug. It questioned the need for a new form of one of most widely-abused prescription drugs in the United States. The approval also came a day after the FDA said it would support stronger restrictions on combination drugs containing hydrocodone."
I strongly recommend exhausting your options before resorting to a narcotic pain reliever. It's quite clear that these drugs are being overprescribed, and can easily lead you into addiction and other, more illicit drug use. I strongly suspect that the overreliance on them as a first line of defense for pain is a major part of the problem. Remember, no matter what type of painkiller you choose, it will come with potentially serious risks to your health. I believe there are better alternatives. If you are suffering from pain, whether acute or chronic, I recommend working with a knowledgeable health care practitioner to determine what's really triggering your pain, and then address the underlying cause. Remember, along with exposing you to potentially deadly risks, medications only provide symptomatic relief. They do NOT address the underlying cause of your pain.
The following options provide excellent pain relief without any of the health hazards that prescription (and even over-the-counter) painkillers carry. If you are in pain, try these first, before even thinking about prescription painkillers of any kind. Eliminate or radically reduce processed foods, grains, and sugars from your diet. Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory prostaglandins are produced. That is why stopping sugar and sweets is so important to controlling your pain and other types of chronic illnesses. Start taking a high-quality, animal-based omega-3 fat. My personal favorite is krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work; they manipulate prostaglandins.) Optimize your production of vitamin D by getting regular, appropriate sun or safe tanning bed exposure, which will work through a variety of different mechanisms to reduce your pain. Emotional Freedom Technique (EFT) is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system. It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you rebalance your energy system, which tends to dissipate pain. Astaxanthin is one of the most effective fat-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than anti-inflammatory drugs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit. Ginger: This herb has potent anti-inflammatory activity and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice. Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility.12 A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.13 Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients. Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple, including some of the bromelain-rich stem, may also be helpful. Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this. Evening Primrose, Black Currant, and Borage Oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain. Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain. Methods such as yoga, Foundation Training, acupuncture, meditation,14 hot and cold packs, and other mind-body techniques can also result in astonishing pain relief without any drugs.
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