The Prescription Pain Medication [Non-] Crisis

In the 1980's, there was a panic involving child kidnapping. If you didn't live through it, it is difficult to understate how ridiculous it was. Children's faces were being printed on milk cartoons. TV stations were running reports at half-hour intervals. This panic was driven by lazy and uncurious news reporting and by statistics that included domestic disputes into reports of "kidnapping."

Today, we have the same issue with opioids.

The Federalist has published a superb article pertaining to the conflation of prescription pain medications with the deaths being caused by the abuse of illegal opioids, primarily fentanyl. From the article:

Although opioid-related deaths are driven mainly by heroin and black-market fentanyl, you would not know that from most of the press coverage, which emphasizes pain medication prescribed to patients who become addicted, overdose, and die. This narrative is “fake news.”

Just 30 percent of opioid-related deaths in 2017 involved commonly prescribed pain pills, and most of those cases also involved other drugs. People who die after taking these drugs typically did not become addicted in the course of medical treatment. They tend to be polydrug users with histories of substance abuse and psychological problems.

To give you an idea of how incredibly inflated the "opiod pain pill" panic is, here are the real numbers:

In a 2018 study of about 569,000 patients who received opioids after surgery, for example, just 1 percent of their medical records included diagnostic codes related to “opioid misuse.” According to federal survey data, “pain reliever use disorder” occurs in 2 percent of Americans who take prescription opioids each year, including non-medical users as well as bona fide patients.

After surgery? 1%. Total misuse? 2%, which includes people who were never prescribed the medications in the first place. Does that seem like a crisis to you?

Who are the victims of this unwarranted panic? People who have chronic pain like yours truly (fibromyalgia, CFS and severe back issues). Here is what two of them wrote:

Here in Kansas, when Governor Colyer set up his opioid advice panel, I contacted them -- twice -- and recommended they have a chronic pain patient among the physicians. nurses, lawyers, etc. They did not reply to my first message. The second was replied with, "No need. Your point of view is represented by the doctors and nurses on the panel." While I am sure their intentions were good -- respectfully, having medical professionals is not the same as having one or more chronic pain patients. Particularly, as noted above, we are being treated as drug addicts just to get a prescription renewed.

The Federalist article goes on to read:

Desperation for Chronic Pain Patients?

Many of these patients used their prescriptions responsibly for decades, but they are now being pushed into trying dangerous surgical interventions or desperately buying drugs off the street. Reporters like Kennecke are helping to push chronic pain patients past their breaking point. It’s a pointless sacrifice, since opioid-related deaths have continued to rise even as prescriptions of pain medication have fallen dramatically.

Even if all of the inaccurate and hyped reporting were to cease tomorrow, the damage will take years to undo. Politicians do not like to admit they were wrong.

Going forward, remember the Hypocratic Oath: First, Do No Harm.