Clearly both are real issues in public health, and tragedies for families most directly affected.
But there is ample evidence that neither sad outcome is the core reality of drug abuse in the US.
As recently explained in by neuroscience journalist Maia Szalavitz , “Opioid Addiction is a Huge Problem, but Pain Prescriptions Are Not the Cause.” As Szalavitz points out, “efforts to reduce opioid deaths will fail unless we acknowledge that the problem is actually driven by illicit — not medical — use.” Likewise, “…according to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.” The real problem is not chronic pain patients.
Part of the solution might be securing of potentially addictive medications under lock and key when used at home.
As a clinician, I have noticed certain medications being used more frequently over the past few years. I’ve used Abilify for its approved indications—psychosis, acute mania, maintenance treatment of bipolar disorder, and adjunctive treatment of depression. But I’ve also seen Abilify prescribed for a panoply of off-label indications: “anxiety,” “obsessive-compulsive behavior,” “anger,” “irritability,” and so forth. If you ask patients, they’ll say that—in general—they tolerate Abilify better than other atypical antipsychotics.
It’s not as sedating as Seroquel, it doesn’t cause the same degree of weight gain as Zyprexa, and the risk of contracting uncomfortable movement disorders or elevated prolactin is lower than that of Risperdal.
If this was a game that involved high level raiding, she would probably be a lot more careful. ” So as far as I could tell I didn’t get even a tiny bit high, and if I did, I don’t see what the big deal is cause I didn’t notice anything.
Some readers will also be familiar with a different kind of crisis and its policy tangles, in the difficulty which many people encounter getting medical assistance for chronic intractable pain.
It should challenge our theories of neurotransmitters and receptors and how their interactions underlie specific symptoms.
And it should give us reason to question whether the “stories” we tell ourselves and our patients carry more weight than the medications we prescribe.
I have previously written at MIA concerning the inappropriate application of psychosomatic medicine to people who are written off as “head cases.” (See “It’s NOT All In Your Head”) I would now suggest that a largely bogus “war on drugs” has also become a war against pain patients.
And at this stage of public discussion, pain patients seem to be losing.