Oxycodone tablets

The opioid crisis keeps accelerating. While watching NBC News last night we saw yet another heartbreaking story about the devastating impact opioids are having across America. Three people in Dayton, Ohio were brought back from the brink of death thanks to naloxone (Narcan). Many other people aren’t so lucky. There is no doubt that opioids have caused countless overdose deaths and untold misery.

Controlling the Opioid Crisis:

If you follow the news you have seen it called the opioid crisis, the opioid epidemic and the opioid emergency. Politicians bemoan the ongoing disaster but seem stumped about what to do about it. Every day emergency medical teams across the country have to rescue people from opioid overdoses.

It wasn’t supposed to be like this. Three years ago the DEA (Drug Enforcement Administration) clamped down on prescription pain relievers containing opioids. Prior to 2014, hydrocodone (Lortab, Norco, Vicodin, etc) was a Schedule III drug. Doctors could fax or call in a prescription or refill to a pharmacy. They could also write electronic prescriptions that went straight to the pharmacy computer.

Physicians must now write a paper prescription that is only good for one month at a time. There are no refills. The FDA and the CDC have also warned physicians to be extremely cautious about prescribing opioids like hydrocodone and oxycodone (OcyContin). And many pharmacies have made it much harder for patients to get access to such medicines. And yet the opioid crisis worsens.

What Went Wrong?

Despite the DEA’s war on opioids, the epidemic has seemingly worsened over the last few years. If physicians, pharmacists and drug companies are making it harder for patients to get powerful pain relievers, how come so many people are overdosing and dying?

Illicit Fentanyl:

Part of the answer seems to come from China. Synthetic opioids like powdered fentanyl (and chemical cousins) are flooding into the country. These illicit, manmade compounds are far more potent than heroin. Sometimes they are made into pills that resemble weaker prescription analgesics. But these potent chemicals are killers.

According to NBC News:

“The death rate of synthetic opioids, which includes fentanyl, rose more than 72% from 2014 to 2015, according to the Centers for Disease Control and Prevention.”

NBC News attempted to order fentanyl using the Internet:

“Attempting to order fentanyl online from China came with a dose of customer service — complete with smiley face emoticons and an explanation of paying with bitcoin. NBC News did not go through with the purchase of the drug, but the Drug Enforcement Agency says mainland Chinese companies are known to manufacture and distribute fentanyl and other illegal drugs using e-commerce.”

Pill mills, where unethical doctors wrote huge numbers of prescriptions for opioids, have mostly been shut down. But that has not solved the opioid crisis. The current epidemic seems to stem more from illicit manufacturing abroad than the diversion or abuse of legally prescribed opioid analgesics at home.

The History of Opioids:

While federal officials focus on the devastation caused by opioid abuse, they seem to be ignoring the suffering of people who no longer have access to the pain killers they need to function.

People have been using opioids for more than 5,000 years. That’s because the active ingredient from the opium poppy remains one of the most effective pain relievers known to humankind. From the ancient Sumerians, Assyrians and Egyptians to today’s manufacturers of oxycodone and hydrocodone, humans have found ways to use-and abuse-opioid compounds.

The Opium Wars:

Nineteenth-century China had its own opium abuse crisis. Both the British East India Company and American traders found it profitable to ship opium into southern China, even after it was declared illegal. The British and the Chinese fought two wars over this trade.

Opioids for Pain:

No health professional disputes the value of powerful opioid narcotics for treating severe pain. Such drugs as hydromorphone (Dilaudid), methadone (Dolophine), morphine (MS-Contin), oxycodone (OxyContin) and fentanyl (Duragesic) are all used to control intractable cancer pain.

Patients in hospice or hospitalized cancer patients are still treated with such medications. But people with chronic, non-cancer pain are now feeling abandoned. That’s because the measures taken to control the opioid epidemic have left many of these patients without recourse.

One reader shared this sentiment:

“Isn’t it time people like me who are disabled and suffer from severe nerve pain fight back? I can’t function, walk, sleep or cook for myself without opioids for my pain. How many thousands of legitimate chronic pain sufferers are being adversely affected by the opioid crisis?”

Phyllis in N. J. is desperate:

“My quality of life is horrible now without my pain medication. I guess the government is now in the business of practicing medicine. I’ve written so many letters, comments, tweets, editorials, signed petitions, you name it to get this law overturned. I hope it is in our lifetime, mine and yours, fellow sufferers, that we are treated more fairly. Our doctors have had to watch us suffer unduly. May God help us all find relief in getting back our medicine or getting something better that no one can take from us.”

S. in PA is also beyond desperation:

“From the time I needed pain management until now, my patient experience has been nothing short of demeaning, disrespectful and disgusting. The office staffs at numerous clinics acted like I was an inconvenience instead of a person. I am a health professional myself–an x-ray technician.

“I have 4 children, a greenhouse business I am attempting to begin and a life to live. I understand the opioid addiction problem is a real issue in the United States. But the opioid addicts are going to get what they want no matter what. The only people suffering here are the pain patients.

“I have herniated disks from t3-t4 disk space down and through my spine. I also have bidirectional scoliosis, levoscoliosis, degenerative disk disease, osteophytes, sciatica, arthritis, SI joint dysfunction, and hip popping syndrome to name just a few. I’m 33 years old.

“I’m out of medication, sick and in pain and they don’t care. And they have the nerve to ask if we are depressed. No, we are in pain and no one will help us!

“All I want is to be able to work and live with a quality of life that allows me to live my life a little bit. Because this isn’t living. It’s existing. Being scared month to month because we may or may not get medication from the doctor – or we failed one of the millions of hoops that we have to jump through. Or the pharmacy doesn’t have it. Or won’t let us have it. Or the insurance company won’t authorize it.

“People in chronic pain are dying. People are committing suicide. And the cause of death will be listed as suicide. Depression. No! They died because they couldn’t live with the daily minute-to-minute pain. No one can live with it. And when the physicians won’t help or listen – someone should be held accountable.

“Someone has to speak up for chronic pain patients. But we have no voice. And that, my friends, is the most depressing thing of all.”

Another reader shares:

“I’ve been through six failed lower back operations resulting in damage and scar tissue on the nerves. In my upper back I have multiple bone spurs sticking me in my nerves and two bulging discs in my neck. I need to have both knees replaced. I’m at the very end of my rope. My pain management doctor has cut my pain medications way back and I just can’t take it. I’m thinking of ending my life.”

We have heard from hundreds of desperate pain patients who can no longer access medicines that allowed them to function. Most insist that they have never abused the opioids their doctors prescribed. Yet many are now faced with suspicion from physicians, nurses, pharmacists and insurance companies.

Can We Solve the Opioid Crisis?

Well-meaning federal officials thought they could overcome the opioid crisis by cracking down on prescription opioids like hydrocodone. If anything, the crisis has gotten worse since the DEA changed the classification of this drug.

We need to find more effective strategies to stem the tide of illicit fentanyl and other synthetic opioids flooding into the country from abroad. We should not make chronic pain patients suffer because of this growing illegal drug trade.

Equally important, the pharmaceutical industry needs to develop safe and effective pain relievers to replace opioids. NSAIDs, antidepressants and anticonvulsants are not the answer. And regulators need to make sure that their policies do not punish people in severe pain unfairly.

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  1. Hillary
    FL
    Reply

    I recently heard about ear neurostimulation. My mom is trying it now, so too soon to see results.
    It is non-invasive. Looks kind of like a hearing aid you wear for 2 weeks on, 1 off and repeat two more times. It is FDA approved, so Medicare and some insurance companies cover it.

    It works by stimulating your vagus nerve, which releases endorphins to alleviate pain naturally.

  2. LI
    Reply

    I am a psychotherapist who has treated substance abusers, among other clients. Dependence and addiction are not synonyms; they are quite different. One can be dependent upon a drug and not addicted to it. If one takes an opioid long enough, one is likely physically dependent upon it and might well suffer some sort of withdrawal syndrome if one abruptly discontinues it. One, however, is not necessarily addicted to it. An addict centers his or her entire life around the obtaining and use of the opioid; he or she lets other responsibilities slide, bills go unpaid, and often engages in illegal activities in order to obtain and use the drug. Those who use an opioid as prescribed (in the correct amount and dosage) for chronic pain do not fit this picture.

  3. Lou
    Dallas
    Reply

    Prohibition didn’t work! The “War on Drugs” has been a dismal failure for decades, and will continue to be a failure because the demand for narcotics continues to escalate by many people who don’t know what chronic, unrelenting pain is like. I, too, am a retired RN, who after 25 years of working in a Level I Trauma Center, began having back issues. I’ve had numerous procedures/tests/scans/etc. While nothing has totally eliminated the pain, I do okay as long as I can take my pain medicine, which for me, is a low-dose Codeine-containing tablet. I have a pretty decent life. I have a wonderful, supportive spouse, walk 3-4 miles a day (most days), and really try to make the most of my life.

    I have a great job, working in logistics for a transportation company. The problem with pain is that there is not a medical device that we can be hooked up to so our pain can be MEASURED! I too am increasingly frustrated with the way many medical providers treat us like criminals. I have never abused my medications, and I would never wish for my worst enemy to have to walk in my shoes for even 24 hours. I am frustrated with the DEA, with pharmacies who choose not to fill certain prescriptions, and I feel frightened constantly that I may not be able to continue to have a decent quality of life if my medication changes from Schedule III to Schedule II, or if my doctor just decides that he no longer wants to prescribe narcotics for me. Have there been people who misused the system? Absolutely! But LISTEN: I believe there is power in numbers, and those of us who are legitimate pain patients must not be silenced!! PLEASE, don’t give up on finding relief, but LET YOUR VOICE BE HEARD!! We deserve better treatment, no ifs, ands or buts!! You’re ALL in my thoughts and prayers!

  4. Gina
    Chapel Hill
    Reply

    I have a series of conditions, some of which have caused debilitating pain for almost a decade. It affected my marriage, now divorced; it affected the ability to work because I could no longer handle the pain in my back, my wrists and my lungs.

    So I went to visit Colorado this summer. I was able to go without many of my meds thanks to the legalization of cannabis creams that I place on my areas that were hurting the most. Incredible relief! Now I am careful not to overdo some of the things I did when I was much younger, but all-in-all I am able to function. The FAA would have had a field day with me if I had carried some back in my luggage so I did not risk it. But I am willing to drive my car all the way out to Colorado and back to get a box of the CBD cream that helped me so much and allowed me to temporarily get up some of my meds as well as enjoy movement in life again!

    Why can’t the Feds see the value in cannabis? I was not an old hippie–though I am almost 60 years of age. I just was desperate to get out of pain which in turn, allows me to be a nicer person to others and to sleep at night.

    Thank you for listening!

  5. Bobby
    Mid MD
    Reply

    It is quite perplexing that the government tried to make things better but they actually got worse. Usually a government fix works like a charm. Maybe a few more laws could help.

  6. Frances
    NC
    Reply

    Why can people in charge of options not understand that the majority of people who need them are not abusers? I have had both knees replaced, back surgery which needed metal plates to stabilize. My bones crumbled when the doctor tried to screw them in. I have degenerative bone disease, arthritis, and idiopathic neuropathy in both legs and feet. Also, diagnosed with chronic pain disease. I do take oxycodone limited to two per day, fentanyl patch every seventy-two hrs., and robaxin six per day. Doctor changed last med listed to three per day because a side effect was falling. I had not fallen. Each day is a trial to walk with a walker. As a senior citizen, one finds doctors do not care.

  7. Joan
    FL
    Reply

    I have been taking Vicodin for many years. I have RA [rheumatoid arthritis]. My hands are crippled, my legs hurt when I walk, my right ankle turns sideways. I have had 3 broken bones in my foot in the past 7 months.

    If I didn’t have 3 Vicodin a day I could not function. I can’t see how people taking only 3 or 4 Vicodin a day can get high. All it does for me is take away some of the pain.

    It is difficult to get someone to go to the Drs office every month to get the prescription. I do not drive any more because I’m afraid I will kill someone. I must depend on others for my daily needs. I believe it should be up to a Dr that knows you well how much if any pain killers you get not a government agency. I am 77 years old and would at least like to spend my last year’s in comfort.

  8. Bridget
    Wisconsin
    Reply

    I have a very rare form of arthritis in my hands and feet. My fingers are swollen, twisted joints, and excruciating pain. I can’t write or even tie shoelaces. My feet hurt so much I have trouble walking, and don’t do any of the things I used to.

    My rheumatologist told me there was literally no treatment except pain relief. He referred me to pain management. Her solution, after filling out forms that looked like they were written by a child, not to mention a hefty copay, was Tylenol. I had already tried every OTC pain reliever, not to mention the rheumatologist said they were useless. She said she “didn’t do opioids.” How is that pain management? She was nothing more than a snake oil salesman, billing hundreds to recommend Tylenol.

    If other countries treated you like a person and I was physically able to do so, I would leave the US in a minute.

  9. Anne
    Wisconsin
    Reply

    It makes me wonder why these drugs are so attractive in the first place and if they are so lethal, then why do people keep taking them? Who are the biggest abusers?

    I remember being in high school and watching a movie on smoking pot. Maybe there was something on LSD, as well. Part of the problem was what we were being told didn’t fit into our own experiences. No one looked in the mirror after smoking pot and saw themselves as a monster. So pretty soon you thought these people don’t know what they’re talking about. On the other hand, most of us were terrified of heroin because there was enough legitimate information out there to scare us away.

    I’m not saying we didn’t have drug problems then, but this seems a lot worse. And making it hard for the people who really need them is inhuman.

  10. Peggy
    Mississippi
    Reply

    I’m in Pain Management – a patient – and they’ve done procedure after procedure on my back – all of which gave me various degrees of relief. My pain issues stem from a fall I sustained in December of 2014 and from an earlier fall back around 1999-2000 – I don’t remember exactly when but I remember the event. They found I had 2 compression fractures in my thoracic spine – one for each fall.

    Because of other medical issues, I seem to be limited to either RS Tylenol and/or Tramadol plus certain muscle relaxers and versions of Lidocaine. I’ve asked if there’s anything else they can give besides these and the answer has basically been no!

    I’m afraid of getting addicted to a pain drug because because I lost a cousin to a drug overdose. He was 37 years old and left behind a young son who is growing up without his Dad. Other men are filling that gap but it’s not the same without his Dad being there.

  11. Dorothy
    Florida
    Reply

    As always, when government restricts the innocent get hurt and the illegal goes on. I know of someone who has been in constant pain for years and can’t get her meds. Her kids told her to “go to the street corner” to get what she needs. She is NOT doing that…yet.

  12. David
    Florida
    Reply

    This crisis was made by doctors and Big Pharma – and can be solved by them. Take the opioids off of the market NOW!

    • SNH
      Reply

      Let’s see. Restricting the market hasn’t solved the problem…in fact made it worse. So it’s hard to see how removing them altogether will solve anything.

    • Becky
      California
      Reply

      David in Florida: obviously you have never suffered unrelenting pain. Be careful what you wish for because you or someone you love could need opioid meds in the future & if these drugs are taken “off the market NOW” you might be in for some unbelievable & unnecessary suffering.

  13. Terry H.
    NC
    Reply

    I must use morphine daily to be able to function, not because of addiction, because of the searing pain in my head after a TBI and carotid artery dissection. I must travel overseas to see my family and to save money I stay a few months. I can easily get one month prescription from my provider but must find a helpful doctor while overseas. This means that more than one doctor is prescribing which is generally a bad idea when it comes to opiates.

    There can be no “one size” program. The people who are addicted need help, but those of us that are not addicted and need to function daily need reasonable access and management of our medication.

  14. D V
    Reply

    I thought this article on opiates (pain medicine) was great!!! Said what needed to be said just with out enough gusto!!!!

    We need help NOW!!!!!! NOT NEXT YEAR… NOW!!!!!!!!!!!!!!!!

    I’ve NEVER abused meds and except for when my EX-husband stole my meds I’ve never had a problem keeping up with them!!! The government needs to WAKE UP NOW AND GIVE US SOME MUCH NEEDED HELP WITH OUR PAIN!!!!!!

  15. Sally
    seattle
    Reply

    So people committing suicide because they can’t live with horrendous chronic pain are now less important than a drug addict? Why aren’t BOTH important? And if a doc refuses to prescribe enough pain meds because s/he is afraid of the government, we have a really sad, life-threatening situation

  16. John
    Minneapolis
    Reply

    I have Limb-Girdle Muscular Dystrophy. It was adult onset and I worked unknowingly through my forties at trade labor until I was completely broken down. I have bulging disks, sholders that dis-joint, hips that rattle and I ache all over all the time. I’ve had more kinds of physical therapies than you can imagine.

    Until the crackdown I used opiates to keep some control of the pain. I’d been taking them for many years and not too long ago my pain doc increased my dosage. Then the opioid “crisis” hit.

    Over the past two and one half months my Rx has been cut by half, I’ve been made to appear every two weeks and can only get a two weeks supply. I’ve been urine tested, had my pharmacy refuse to fill my Rx and been treated like a criminal.

    Before this happened, I could still have some productive days, could go out and be in society, converse with friends. Now I stay at home, the various pains are no longer in the back of my mind but now take over my very existence, always present and not ignorable. I can barely move; each physical action requires me to summon resolve. I sleep one to two hours at a time before the pain wakes me. This broken body suffered badly enough before they cut me back and they are not finished yet.

    I sympathize with those who have lost loved ones to the reckless use of these drugs but I can’t help but feel that I am paying a damned high price for the carelessness of these abusers.

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