Seldom Mentioned Downside Of Painkiller Epidemic: Patients Don’t Feel Better

When I signed on board Hospice Inc., in New Haven, Connecticut, in 1975 as a bright 25-year-old who wanted to do some good in this world, the challenge put to me by Florence Wald, a former dean of the Yale School of Nursing who had organized the young organization to build the very first inpatient hospice in the United States (which she succeeded in doing five years later in neighboring Branford), was that we had a mission to reshape public attitudes toward the control of pain in America.

Florence Wald’s experience in the U.S. healthcare establishment was that physicians here were much less willing to use powerful painkillers like morphine in treating the terminally ill than their British or European counterparts because of a misplaced fear of addiction. “Terminal cancer patients don’t get addicted to painkillers,” Florence told me flatly, “nor do they experience euphoria from the use of painkillers. This is a perception that is just dead wrong, and we need to change it. We can treat pain more effectively, and we have a duty to do so.”

In the third of a century since then, the burgeoning hospice movement in America has brought comfort and freedom from pain to millions of Americans facing terminal disease, and eased the predicament of their families, who often suffer as much if not more than their dying relatives. Public attitudes toward painkillers have also evolved dramatically, including the views held by America’s physicians, who have become more willing to condone powerful opioids when they are needed to control pain.

But there may have been a downside to this change in perception and prescription.

Barry Meier is a reporter for The New York Times who has written extensively and eloquently on problems associated with prescription painkillers, a little-discussed epidemic that began about twenty-five years after I concluded my two-year stint with hospice. In June, Meier published an ebook with the “Kindle Single” program at Amazon called A World of Hurt: Fixing Pain Medicine’s Biggest Mistake which explores this chapter of the American prescription painkiller story, which is simply this: There is a growing body of evidence that these pain-numbing drugs, along with causing an epidemic of abuse, are often quite ineffective in treating long-term pain. They may actually be harming patients.

Barry Meier’s first book, Pain Killer: A ‘Wonder’ Drug’s Trail of Addiction and Death, focused on a better-known story about painkillers, namely the pandemic of abuse that occurred surrounding the powerful drug OxyContin, especially by teenagers seeking a new high.

Barry Meier was interviewed by his paper on June 23, 2013, and elaborated on what he was trying to do with his eloquent writings on painkillers, why doctors and patients resist giving them up, and some of the side effects of these drugs.

“A decade ago, drug companies and medical experts launched a ‘War on Pain’ that promoted the widespread use of powerful narcotic painkillers for common conditions such as back pain,” Meier told the Times. “Specialists claimed that a ‘bright line’ separated the drugs’ benefits for patients from their dangers when abused on the street by young people and others.”

Today, Meier says, many of those same experts who once endorsed painkilling drugs have had a change of heart. They have reached the revised conclusion that the opioid boom “ranks among medicine’s biggest mistakes.” They cite recent studies that tie long-term use of these drugs, particularly at high doses, to addiction, dependence, reduced sexual drive, lethargy and other problems. Based on stories of researchers, patients and others, A World of Hurt highlights how treating pain differently can benefit both pain patients and the public’s health. “The promise that high-powered drugs could provide a cure-all, the key to winning the ‘War on Pain,’ was an empty one,” Meier asserts.

Meier’s critics will argue that the compelling anecdotes and stories he puts forward, along with references to various studies, don’t make a case strong enough to deprive patients who suffer from pain from the medications that allow them to manage it. No one claims pain control is perfect, and the jury is probably not in yet when it comes to assessing the level of abuse or misuse. More work will need to be done. But I see the pendulum swinging the other way today than I saw it moving in 1975.

What is the answer? Perhaps a better scientific understanding of the brain mechanisms of pain will help us uncover new medications that act differently than opioids? Meier will surely find fertile ground for continued writing on this subject for many more years. In the meantime, he has made a significant contribution to public understanding of pain and pain control, and his new ebook is a marvel of clarity and concise writing. I heartily recommend it.

Don’t Sweep It Under the Drug! – By: Dr Cathy Rosenbaum – Book Review

Finding the right balance in life for health of body and mind has become more difficult in today’s increasingly complex world. The world generally focuses on maintaining a youthful appearance, but this may not be the best way to achieve wellness. Indeed, this is especially true for Baby Boomers, who are now facing various medical issues as they mature. Because of busy lives and hectic work schedules, it is often easiest to take multiple prescription medicines as well as the ever popular dietary supplements, thus covering up the symptoms but often not dealing with the actual cause. A semblance of bodily health might be achieved, but important aspects of a person’s life are ignored in the process.

Finding a better way is possible, and Dr. Cathy Rosenbaum provides the path towards wellness in her book, Don’t Sweep It Under the Drug! First, with the guidance of a medical professional, Baby Boomers, as well as the rest of the population, can better manage their prescription medications. Carefully reviewing these medicines along with any dietary supplements can help eliminate the dangers of drug interactions and minimize any adverse side effects. Similarly, incorporating complementary practices, such as massage and aromatherapy, and making lifestyle changes can further be of benefit. No wellness program would be complete, though, without attention to relaxation and spiritual development. By taking this holistic approach, even those with chronic illnesses can begin to feel better and more at ease with their aging process.

Among the many health-related books available on the market, Dr. Rosenbaum’s book offers Baby Boomers with a balanced way to achieve health, both of body and mind. As a pharmacist and medical professional, Rosenbaum has a unique insight into the pharmaceutical industry and gives readers an overview of the fundamentals of drug approval, polypharmacy, drug interactions, and more. Additionally, she outlines some alternative approaches to medication that readers can explore with their doctors. Indeed, all of the information provided would be difficult to obtain elsewhere. Rosenbaum’s explanations of complex issues such as drug interactions are extremely accessible to average readers and give them the needed background to better improve their health. Don’t Sweep It Under the Drug! also includes many practical strategies for improving wellness, including an emphasis on spiritual development, something that is sorely lacking in many similar books.

Dr. Rosenbaum’s passion for helping others is clear in her book. What started with a family member’s health crisis has become for her a way to walk alongside others as they make gradual changes to improve their lives. Certainly Rosenbaum’s book is written for Baby Boomers and so would directly appeal to their needs and values, but the book would easily have value for anyone attempting to maneuver through a maze of prescriptions, dietary supplements, and lifestyle changes. Brief and yet filled with important insights, Dr. Cathy Rosenbaum’s Don’t Sweep It Under the Drug! is a necessary addition to the library of any reader, whether young or old.