COOS BAY — A highway billboard that pictures a cornucopia of capsules, tablets and pills cascading toward the viewer. Across the image, the printed message asks, “Got pain?”
For decades, drugs have been the answer to soreness aches and throbs. If you feel poorly, pop a pill. Or two. Or three. Or more.
But the avalanche of pain-relieving medications threatens to smother the nation in addiction to prescriptions, say health care specialists from the local to the national levels. Pills may kill more than pain. They can kill patients.
The big sleep
Eight million Americans will go to sleep tonight with the help of opioid medications, drugs that include morphine and others that are derived from opium, says Linda Hicks, RN, community health education coordinator at Bay Area Hospital.
One hundred of the sleepers won’t wake up tomorrow, she said.
That figure doesn’t include the number of people who will become addicted to painkillers prescribed by their physicians, bought on the black market or pilfered from a friend or family member.
“We don’t know who is going to be addicted until it happens,” Hicks says, calling the licit and illicit traffic in painkillers “the Russian roulette of medicine.”
Her concerns are echoed by Rachel Stappler, PA-C to Dr. Basil Pittenger, MD, FACP, at North Bend Medical Center and a local leader in the campaign to control pain-controlling medications.
For more than 15 years, Stappler says, the pharmaceutical industry has made “a big push for pain to be the fifth vital sign” besides blood pressure, temperature, pulse and respiratory rate.
We’re No. 1, gulp
The result: Oregon was the No. 1 state in the nation for overprescribing opioid drugs, according to the U.S. Substance Abuse and Mental Health Administration. Doctors saw a parade of patients requesting refill after refill of their painkillers — even though pharmaceutical companies had assured physicians opioids weren’t addictive when used to control pain.
It simply wasn’t so, and now that doctors are applying the brakes to prescribing opioids, patients feel helpless and angry besides suffering in pain.
Hicks describes patients’ typical reaction to being cut off from oxycodone, hydrocodone, Tramadol and other narcotic analgesics as “what a rip-off! I have chronic pain but I don’t get narcotics? Everybody used to get them.”
Nix to Moxduo
The FDA still could OK the powerful drug, developed by Australian pharmaceutical firm QRxPharma Limited, but many medical experts consider the drug too dangerous, especially in light of rising opioid addiction.
“I believe that’s likely to exacerbate an already severe public health crisis,” Dr. Andrew Kolodny told National Public Radio the day before the committee’s decision. Kolodny, a California physician whose expertise is treating drug addicts, leads the national group, Physicians for Responsible Opioid Prescribing.
Closer to home, Stappler has been instrumental in encouraging health care providers to curb opioid prescriptions voluntarily. She helped establish the Coos County Pain Oversight Committee, which she calls “one of the best things I ever did.”
She also has lectured on chronic pain at state and local health conferences and participates in the University of Washington Tele-Medicine Pain Research Study, which each week connects top pain specialists from across the western U.S.
More, better treatments
While Oregon hasn’t established the Morphine Equivalent Dosing that’s in force in Washington state, physicians are encouraged to inform patients of alternatives to painkilling drugs
Stappler and Hicks both call for insurance programs to better cover treatments like physical therapy, occupational therapy, acupuncture and acupressure.
Other alternatives include mental health treatments known as behavioral medicine, or B-med. “Mental health can help you unlock so much,” Stappler says.
The shift won’t unsettle only patients, she adds. Doctors must learn that there’s more to treating pain than prescribing pills. Instead, they must inquire into a patient’s mental health and history of substance abuse.
“Are you paying attention to what your patients are telling you?” she asks physicians.
“Gone are the days of just handing out scripts.”
James Casey is a freelance writer who lives in North Bend. He has received chronic pain management treatments from Rachel Stappler, and chronic pain counseling from Linda Hicks. He uses meditation as one of his pain control techniques. Contact him at email@example.com.