In my medical training in the 1970’s I was taught not to prescribe opioids for chronic, non-cancer pain because they didn’t work well enough to justify the risks.
A 1986 article subsequently questioned that assessment. The case study reported on 38 chronic pain patients that had achieved adequate long-term pain relief from opioids with acceptable side effects.1 The authors stressed that more extensive studies were needed to confirm the findings. Confirming studies were never published, but drug companies began aggressively promoting prescription opioids as safer and more effective than previously believed.2
In the 1990’s the prevailing medical practice sentiment concerning opioids changed dramatically. In 2001 the Federation of State Medical Boards went to so far as to recommend punishing physicians that under treated patients with chronic pain. It was charged that physicians had become callous to patients with pain, suggesting that more liberal use of opioids was beneficial.3
In 2001 Purdue Pharma spent $100 million to market the drug OxyContin. In 2002 the revenue from OxyContin increased to $1.5 billion and by 2015 total sales of OxyContin had reached $35 billion.4
By 2010, the increase in prescription opioid addiction and overdose deaths was becoming widely recognized. The magnitude of this problem boggles the mind:
- Enough opioids are prescribed each year for every American to have a 30-day supply,
- The CDC estimates that 2.1 million Americans are addicted to pain medications,
- There were over 16,000 deaths from overdose of opioid pain meds in 2013, and
- The non-medical use of prescription opioids in 2015 was estimated to cost insurers $72.5 billion in medical bills.
The prevailing medical guidance has now reverted to the perspective of forty years ago; avoid prescribing opioids for chronic, non-cancer pain because they don’t work well enough to justify the risks.
Unfortunately, the addiction situation will almost certainly get worse before it gets better.5
As physicians reduce opioid prescriptions under the current recommendations, many of the 2.1 million people addicted to opioids will continue the switch to heroin.
I have described the progression of this epic tragedy to energize policy makers to consider ways to profitably invest in efforts to avoid such catastrophes in the future.
Breakthrough To Better,
Carl
PS – The next Conversations addresses the dichotomy between the current scenario of our health and what is possible with better health decisions.
1Case review of opioid risks vs. benefits
2Senate testimony on America’s opioid addiction
3State Medical Board policy on opioid treatment
4OxyContin sales
5Position paper calls for new guidelines
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Switch Conversations is a bi-weekly blog exclusively for our potential employer partners.
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ALL POSTS:
Edition 1 – Solving a Well-Entrenched Problem
Edition 2 – A Case of Dr. Jekyll and Mr. Hyde
Edition 3 – Best marketing tagline of all time?
Edition 4 – Post-Truth Killed a President
Edition 5 – What’s an employer to do?
Edition 6 – Profiting From the Opioid Epidemic
Edition 7 – The Keys to Unlocking Better Decisions
Edition 8 – When Difficult Things Need to be Done Well
Edition 9 – Fixing Healthcare
Edition 10 – Beware of a Singing Cow
Edition 11 – Wise Reflections
Edition 12 – Warning: Reader Discretion Advised
Edition 13 – Can AI save healthcare? (Part 1)
Edition 14 – Can AI save healthcare? (Part 2)
Edition 15 – Can AI save healthcare? (Part 3)
Edition 16 – Embracing Reality to Improve Healthcare
Edition 17 – Everything I Needed To Know…
Edition 18 – The Eighth Circle of Hell
Edition 19 – So… What’s Our Solution?
Edition 20 – Protecting Integrity as a Core Strategy
Edition 21 – An Unadorned Legacy
Edition 22 – Time to Grow Up
Edition 23 – Against All Odds
Edition 24 – When Everyone Has Stopped Listening
Edition 25 – Focusing on What’s Important
Edition 26 – Don’t Give Up Your Shot
Edition 27 – Join the Goodhood
Edition 28 – Fixing Healthcare (Recycled)
Edition 29 – Taming the Healthcare Beast
Edition 30 – Leadership
Edition 31 – Better Health Requires Good Sense
Edition 32 – Little Decisions With Big Consequences
Edition 33 – Transformational Courage
Edition 34 – Transformational Courage – Part 2
Guest Post – Happy Thanksgiving! By Jeff Novick, RD
Edition 35 – Transformational Courage – Part 3
