“Pain is inevitable, suffering is optional,” a quote by American author M. Kathleen Casey
Roughly a 100 years ago, physicians considered pain as essential for healing. Recently, pain has become recognized in the healthcare system and is now focused on when managing or curing disease. Generally, over 50 million Americans suffer from chronic pain, according to the American Pain Foundation. The question is, how are we going to manage it?
Unfortunately, medication is often overprescribed, sometimes abused, and in certain cases eventually leads to addiction. The Rhode Island Department of Health recognizes drug overdose and abuse as a public health crisis. They predict these numbers are rising, reporting upon particular opioids raising high concern.
“Fentanyl, a highly potent opioid, poses a great threat and exacerbates our overdose crisis. The number of overdose deaths related to fentanyl has increased 15-fold since 2009,” according to the Department of Health.
“Rhode Island is having overdoses everyday…as we speak individuals are overdosing” said Mark Robbins, a professor in the psychology department.
Often, these individuals are not intentionally trying to take their own life. Rather, this is a health care crisis with a deeply rooted problem. Prescriptions are being over prescribed to patients in response to pain. The brain quickly adapts to opioid pain medication, building tolerance. Next time, the individual may be inclined to take more medication, placing them at risk of overdosing.
What’s driving the high number of pain prescriptions? Revenue. OxyContin, for example, was the 25th highest selling medication in 2016, with profits exceeding $5.2 billion. Through making this controversial opiod, the Sackler family, who owns the company that produces OxyContin, Purdue Pharma, reaps the monetary benefits, ranking among the richest U.S. families. But at what expense? What will it take for pharmaceutical companies to hold ethics above revenue?
“We make opium out of poppy seeds. It doesn’t stop there, heroin, synthetic opioids too,” said Robbins.
Although pretty looking flowers, they hold deadly impacts upon public health. There are two avenues people may access these drugs: legally with a prescription or through the illegal drug markets. Those purchased illegally are not regulated by the FDA (Food and Drug Administration), and run the risk of being laced and dosage is not monitored.
“We, the United States as well as New Zealand, are the only countries that directly market pharmaceuticals to the public,” said Robbins.
Often, advertisements may be misleading. Patients may trust that these pharmaceuticals are safe and feel inclined to take their prescription. However, what’s not being disseminated is the addictive roles these drugs hold.
“We have opiate receptors and endogenous opiates,” Robbins said.
Essentially, the human body has built in regulatory mechanisms to respond within our environment. Specifically, the nervous system creates neurochemicals, some of which are involved in pleasure. Many people may have heard of the reward system. Formally known as the limbic system, it responds creating our “happy chemicals,” naturally found within the body. However, opioid medication capitalizes on this reward system, making it the target of pharmaceutical pathways. These drugs are able to cross the blood brain barrier (your defense within the brain), bind to receptors and impact how the nervous system functions.
“Just two weeks ago, Purdue Pharmacy agreed to stop marketing to physicians oxycontin in response to pressure from lawsuits,” said Robbins.
Although only a start, stricter regulations on marketing and the number of prescriptions written will be critical. Other methods of pain management include physical therapy, meditation, exercise prescription and psychological/behavioral avenues. Perhaps through increasing awareness and funding for psychological research, humanity may remedy the opioid public health crisis.