A patient goes to their primary care physician for chronic low back pain that they have been suffering through for years. He explains that he is"fed up with dealing with pain and doesn't know what to do anymore". His physician decides to prescribe him Hydrocodone to use as needed to manage pain. Fast forward a few months and the same patient now is admitting himself into a rehabilitation facility for narcotic use after becoming addicted to opioids. This story is not based on one individual but is the common path that a lot of individuals suffering from opioid addiction.
Opioids are a narcotic that is derived from the opium plant that is known to work on receptors in the brain and body to reduce pain. These opioids, like seen in the story above, are prescribed too many individuals to manage and "kill" their pain. What many don't know and pharmaceutical companies mis-marketed for many years was the very serious addictive properties that these opioid medications have. This is the source of the opioid epidemic with 126 people dying everyday from an opioid overdose. This epidemic is especially dangerous because it has the potential to affect anyone with access to the medication.
The opioid epidemic is seen in 3 waves, the first with an increase in deaths from opioid overdoses. Pharmaceutical companies misinformation about the addictive properties, and the physicians using these medications to address the up-tic in pain reports. With more reports of pain now that physicians are screening for it, there then came the increase in prescription medications. This was the start of the never ending cascade of deaths and negative outcomes from these prescriptions. The second wave of the epidemic came from an increase of trans-communicable diseases from IV drug users and heroin related deaths. Heroin is a narcotic that resembles opioids. Many individuals turn to heroin because it is a cheaper alternative and easier accessible than opioid medications. 86% of heroin users admitted to being addicted to prescription medications. The third wave was seen when there was an increase in fentanyl related deaths in the country. Street pills and many drugs today are laced with fentanyl which makes these drugs even more dangerous. Fentanyl is a very powerful narcotic that affects the system like opioids but at a much larger and quicker volume. This epidemic is not one that is over but never ending as these addiction take a strong grasp on many Americans.
So how can this affect you? How can we stop it?
If prescription opioids are prescribed to you for pain management, be mindful of the adverse effects and use them only when necessary. Talking to your physician, pharmacist, and/or physical therapist can steer you to other pain managment alternatives or assist you in monitoring your use of the medication. Education and understanding what you are taking and its long term effects is a hugely important step to taking control of your pain management.
Physical Therapy can play a roll in effecting the opioid epidemic through continuing to educate the patient we work with about the effects of these medications that may be prescribed to them or a love-one. PT can also be used as a pain management strategy as we can use what we've been taught to address the issue causing pain or introduce the patient to other modalities to control their pain level.
Don't let the pain killers kill you!
Key Take Aways
Opioids are pain medication that work on the brain receptors to block pain
HIGHLY ADDICTIVE medication that is prescribed to many people
Narcan (Nalaxone) Nasal Spray used to knock the medication off receptors used for people experiencing an overdose.
Physical Therapist can educate and support patient in pain managment WITHOUT use of strong medications like opioids.
resources:
New study shows physician-targeted marketing is associated with increase in opioid overdose deaths. NYU Langone News. https://nyulangone.org/news/new-study-shows-physician-targeted-marketing-associated-increase-opioid-overdose-deaths#:~:text=Counties%20that%20received%20more%20industry,deaths%20than%20the%20amount%20spent. Published January 18, 2019. Accessed September 8, 2022.
Follow the money: Pharmaceutical manufacturer payments and opioid ... https://nyhealthfoundation.org/wp-content/uploads/2018/06/following-the-money-pharmaceutical-payments-opioid-prescribing-june-2018.pdf. Accessed September 14, 2022.
https://www.health.state.mn.us/communities/opioids/prevention/painperception.html#:~:text=The%20United%20States%20makes%20up,80%25%20of%20the%20world's%20opioids.
https://www.cdc.gov/drugoverdose/images/136-die-from-opioids.png?_=05969?noicon
https://www.poison.org/articles/opioid-epidemic-history-and-prescribing-patterns-182
https://oag.ok.gov/articles/after-resting-case-state-points-critical-evidence-shows-johnson-johnson-kingpin-behind#:~:text=Johnson%20%26%20Johnson%20created%20a%20mutant,supply%20massive%20amounts%20of%20opioids.
https://www.npr.org/2022/02/25/1082901958/opioid-settlement-johnson-26-billion
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