I am a country physician who practiced in the drug-infested region of Appalachia. I retired because of severe arthritis and have had three surgeries. I know from studying the science and personal experience that prescription narcotics are not an effective treatment for chronic pain.
Yet, narcotic usage has become rampant and even trivialized as a laugh line on the “Roseanne” reboot, which opened with:
Roseanne: “Did you get the pain pills for my bad knee?”
Dan: “I wouldn’t be the candy man without the sunshine, babe.”
Roseanne: “Whoo my babies.” And Roseanne smiles euphorically.
Anti-inflammatories were previously mentioned and although narcotics and opioids are not specifically referenced, “pain pills” is the vernacular for these drugs and “candy man” is the street term for one who sells illegal drugs. The segment was rebroadcast on the “Jimmy Kimmel Live!” show, compounding the damage.
Drug overdoses are the No. 1 cause of death in individuals below the age of 50. Opioids kill 33,091 Americans a year while 2 million become addicted. And their usage shows no signs of abating. According to the Commonwealth Fund there are two epidemics — one driven by the procurement of illegal street drugs, the other, a prescription epidemic.
It is the latter epidemic which the Roseanne segment captures.
The prescription epidemic has its roots in a perversion in the indications for these drugs which came about from industry marketing representatives and its justification has been traced back to a single non-substantiated letter which was published in 1980 in the New England Journal of Medicine.
I heard the spiel from many industry retailers on the virtues and non-addictive nature of some of the product formulations. All untrue. Even though it is written on a prescription, the prescribed drug is still dangerous and addictive. In some respects, not much safer than the ones bought on the street. Eighty percent of heroin users started with prescription opioids.
In 2014, the American Academy of Neurology stated that for chronic pain “... there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction.”
The reality is that pain pills do not relieve chronic, non-terminal, pain, they make it worse. Yes, they will relieve it for a very short time, but when the drug wears off the pain comes back worse than ever leading to a rapid addiction. On the whole, the pain is worse. It is real pain, it is just being permanently augmented from the exposure to opioids.
I have had three operations with fusion of my neck for osteoarthritis, gout crystals retrieved from a joint and x-ray evidence of pseudogout. I have three forms of arthritis involving multiple joints. Despite this, the extent of my opioid usage consisted of one codeine pill on the night after my last surgery. Yes, my body’s endorphin production can cause me to be tired and my blood pressure goes up when I have an exacerbation, but I can now tolerate the pain. This is far better than entering into the downward family-wrecking spiral of the drug-seeking addict who has become crippled from recurrent pain elicited by a disease which is far less extensive than mine.
Addiction is permanent and caused by a biochemical change in the brain and the modification of pain receptors. “Treatment” offers little hope of a cure; the best it offers is lifelong “maintenance.” It is not the patient’s fault and can happen after as little as one exposure to these medications — especially if they are given for chronic non-terminal pain and, instead of reducing severe acute pain to a tolerable level, they induce euphoria.
Making light of opioid usage results in the normalization of a very serious threat to our society and at the same time the segment perpetuated the myth that pain pills can be used to successfully treat chronic pain from arthritis.
Both ABC and Kimmel need to realize that perception can become reality, a reality our nation does not need to endure.
Kevin Kavanagh of Somerset is a retired physician and board chairman of Health Watch USA.