February 22nd, 2012
02:15 PM ET
Dr. Sanjay Gupta: The truth about prescription medication addiction
Whenever I hand a prescription for pain pills to a patient, I tell them, “Remember not to drink any alcohol when taking these medications.”
For years, we in the medical community thought that simple message was getting through. It turns out we were wrong.
Every 19 minutes someone dies because of misuse of prescription medications. Sometimes it is because they take too much. Many times it is because they forget or ignore the warning their doctor gave about combining the medications with alcohol. And tens of thousands of people die every year as a result.
As much attention as we pay to illicit drugs such as cocaine or heroin, the truth is prescription medications kill more people in this country than those illicit drugs combined. Perhaps it is a perception issue: “It came from a pharmacy, therefore, it must be safe.”
They certainly can be safe, but they can also be incredibly addictive, with more than 1.9 million Americans hooked on prescription pain medications alone.
Researchers are racing to find something that can help, and there are a few promising things in development. A recent study, the first large-scale trial aimed at painkiller dependence, offered some hope.
Almost half of those addicted to painkillers - 49% - were able to reduce their drug abuse when taking Suboxone for at least 12 weeks. The drug works by reducing withdrawal symptoms and relieving cravings.
Unfortunately, the success rate dropped to less than 10% [8.6%] once patients stopped taking the drug. In the study, patients receiving intensive addiction counseling did no better than those who didn’t.
Naltrexone – sold under the brand names Revia and Vivitrol, an injectable, long-acting formulation – has also been used for prescription painkiller abuse. But naltrexone only has the potential to work in patients who are already off the painkillers long enough that the drugs are out of their system.
Truth is most of the researchers I have interviewed over the last decade all seem to agree on one thing: addiction is a brain disease. The latest science shows how the dependence on drugs or alcohol can change the brain chemistry, altering pain and reward centers. As a result of this latest science, the idea of therapy alone to treat addiction is waning.
I should point out that millions of patients use prescription pain medications every year safely, without becoming addicted, and certainly without dying. For nearly 30,000 people a year though, they pay the price with their lives.
As a doctor, I will look my patients in the eye every time I hand them a prescription to tell them the concerns about the pills they will take. It won’t just be a casual reminder about not taking the medications with alcohol, but a forceful warning backed up with scary but forceful statistics. I will remind them that they could become addicted, and they could die. That is our jobs as doctors, and it is one way to save thousands of lives.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
This article seems to blur the line between addiction and dependence. They are not the same. Addiction is a psychological component, while dependence is physiological. Patients may not be psychologically addicted to prescription drugs but they can (and likely are) dependent, even though they're taking these drugs as prescribed. It also concerns me that this article focuses solely on painkillers. Drugs such as benzodiazepines have a much higher rate of dependence and a horrific withdrawal syndrome. Still they are handed out like candy by doctors in both the ER or a clinical setting with absolutely no warning. I should know. These drugs almost took my life when taken as prescribed by a medical doctor. Never once were these drugs described as addictive (or causing a dependence). It's a crime, and it is our medical system that is flawed, not the patient. This article shows how yet again doctors are missing the point.
Can you site the source for your statistics (1.9 million addicted to painkillers)? I'd love to read the study. I'm also curious what behavior qualifies these patients as addicts. Frankly, I think sensationalist media hype like this is responsible for making it difficult or impossible for people with genuine pain issues (cancer patients, for instance) to get the medicines that can make their pain more bearable. Your source please, doc?
ENOUGH IS ENOUGH! 1.9 million people are not HOOKED On pain medication! Stop demonizing those of us that actually NEED it and use it responsibly for pain management. Do you use the same demonizing terminology for someone who takes insulin for diabetes? THEY ARE HOOKED! Give me a break with this. I agree with you that nothing is ever said about the dangers of anti depressants and anti anxiety medication that are 10 times more deadly than vicodin and others. This is a complete disservice of an article.
Paranoid much? Vicodin is not harmless. It is an opiate and it is addictive. The acetominophin is toxic to your liver in high and repeated doses. I know people who have died from using it. I wish you the best id dealing with your addiction and your personailty disorder. You can start by educatiing yourself and looking in the mirror.
Sorry to dispute your numbers,but from daily observation and experience with a constant barage of patients who only want their Hydrocodone,oxycodone,xanax or soma,I think the number is more like 25 to 30 million nationally
RPh guy - agreed 100%. It's at least as many as you mentioned. You and me and our colleagues are WELL aware that there are many, many patients in legitimate pain - but they're not usually as defensive & easily offended as the commenters on this article!
The reason why people are defensive is because of the constant stupidity exersized from doctors and uninformed judgmental pr1cks like wbraddock and others. I hope some day you develop a debilitating pain condition like MS or Fibromyalgia and have a doctor tell you to take an aspirin for it. Walk a mile in someone else's shoes and realize that your pain is NOT everyone else's.
You are cute braddock, I hope to GOD one day you develop a horrific pain condition. People like you DESERVE nothing less. Go get hit by a car and I will be happy to hand you a baby aspirin for your wimpy pain. Drop dead.
Opiates are not indicated for fibromyalgia- just thought you should know.
WRONG INTERNIST. It shows how little you know. I take a pain pill for my fibromyalgia that I have been dealing with for decades. Without it, I would not be able to work or support my family. So SCREW YOU.
It's very difficult to argue with ignorance so I'll choose not to convince you of your misconceptions. However to anyone who abides by logic, science and reason and not name-calling please educate yourself. Below is one of many articles not sponsored by a drug company that delves into the syndrome known as fibromyalgia and the current discouragement of the use of opioids in its treatment.
Am J Med. 2011 Oct;124(10):955-60.
Opioid use, misuse, and abuse in patients labeled as fibromyalgia.
Not to be arguing, and I am sure your doctor knows why they give you an opiate for your Fibro but the Internist is right about opiates not being recommended for it. Lyrica and GABA drugs are the first defense because they block nerves from going haywire.
Agreed Eva... in my practice I take a completely multidisciplinary approach to fibro (i.e meds, cognitive therapy, physical therapy, education, and more). Meds are only one piece of the pie. I do not prescribe opioid meds in these patients because of the phenomenon of hyperalgesia- literally the pain meds make them MORE sensitive to pain. Unfortunately people who state they couldn't live or function without these meds are definitively dependent. This doesn't make you a bad person, but it is real. I encourage you to discuss this with your physician.
Thanks for the link to the fibro article, Internist. Informative read.
/// Lyrica and GABA drugs are the first defense because they block nerves from going haywire.////
I think you need to understand that some patients will not take Lyrica because of the absurd amount of weight that absolutely will be gained by taking it.
I have tried every single drug there is that is non opioid for nerve damage and the one I refuse to take is probably the one that will work. But I know too many people who have taken Lyrica for their chronic pain and gained 100 pounds approx in a very short amount of time.
So, does that mean that the doctor should be able to tell me that since I will not take the Lyrica then I should have no pain relief?
Because if I gain 100 pounds from taking it I will damn sure bring a lawsuit because the doctors know it does this and they know there are other meds for pain relief.
The problem is doctors really dont know much about combating addiction properly. They will put a patient who has a history of addiction on a wean down schedule that is identical to a wean down schedule that a person has not been addicted and their physiological response to the drug as well as their psychological response is far different.
And I can tell you from experience that the psychological response, though superficial, is super real still to the person who believes it. And without dealing with it the ex addicted patient will fall back into addiction.
That is just dealing with temporary pain relief of major pain for ex addicts. Let us just be realistic, some injuries will put an ex addict back on opiates regardless of their history from it.
Let an ex addict get shot in the spine and then spinal tapped and let me tell you, THEY WILL DEMAND the opiates for relief no matter how much they were against them before hand.
There are serious issues with the addiction side of the medical community.
Many doctors don't believe that Tramadol/Ultram is addicting and it is just as addicting as any opiate even though it isn't an opiate and though its withdrawal symptoms may be a bit less than the withdrawal from opiate products.
First, there are many reasons for one person to be proscribed these types of meds. Some of them are not meant for long term use, but rather short term until the underlying cause can be found and hopefully fixed. I said "hopefully" because more times than not there is no fix for chronic pain or PTSD. I take Xanax as needed for PTSD, something I would never wish on anyone. I can go from having a great day to being in complete panic attack mode. Smells, words, songs, you name it, can take me back to a time in my life that causes me to panic and feel like I have zero control. I feel like I'm going to die, or I should say I fear that I'm going to die. This is real, meds if proscribed by a doctor that you have been seeing for along time can and will save your quality of life. No one should ever suffer from pain both physical and Mental.
Now there are the ones who self medicate and that's when people get into trouble. These are the people who take such meds to numb them selves of both types of pain. And they are the ones who will OD and die and this problem is causing problems for people who are currently suffering today.
Again a good relationship with your doctor is a must, they HAVE to trust you, and you must trust them to do what is right for you.
I am so tired of these articles all true CHRONIC pain patients will be dependent after awhile and have withdrawal IF their pain is figured out and resolved. Studies show 95-98% of Chronic pain patients drop Opioid pain meds no problem if their pain is resolved. I am 49 years old been in horrible nerve pain and muscles cramping as well as joint stiffness I have two young daughters and have been on opioids for 5 years. My Pain Management Dr. treats me like s*** and won't do anything anymore except give me a regimen of low dose Opioids. I have to cut pills in half and decide which days I will be 100% worthless. My medication doesn't even take the pain away 50%. I am in constant pain and once you sign that contract with them try finding another PM Dr. it is impossible you have to fire your current PM Dr. in order to even be considered but you are not guaranteed to be accepted by another Dr. so you take the chance of running out of medication before you find another Dr. My PM just got suspended and he is an SOB on giving out pills so if they can take a Dr like him down then there is little hope. My family Dr. gave me my normal scripts for a month until i find another PM well that is taking forever since they pick and choose who they will see based on if they can make any money off you. I finally got my files from my PM and his files on me are so off and wrong it is hurting my chances to ever get help. My medication list has me on over 30 drugs not once when I have told his nurses or him that I no longer take such and such medication have they removed it from my file. for instance I am down for two levels of percocet and numerous nerve blocker pain meds. I am on 3 pills for my pain thats it.
Maybe if individuals would take more responsibility then this wouldn't happen. Now I understand that there are various, complex issues that cause addiction, and we all have our vices. My one friend who was addicted to pk's was very weaked and always talked about how the world was against him, which was obviously untrue, but those were the lies he told himself so he could rationalize his use.
Take responsibility? What about the doctor's that we put our trust into taking responsibility. I have arthritis, for the pain I was given a prescription for Tramadol. Great stuff!! Marketed as a non addicted and a non Narcotic. Wrong. After taking it for 9 months it took another 3 just to wean myself down off of it. When I finally came off of it I was laid up on the couch with flu like symptoms and anxiety attacks that you would not believe. Once THOSE were done for another two weeks I suffered insomnia like crazy. The drug companies and the doctors have got to be more careful with these things. I found out by looking up online that I was not the only one that became addicted to these horrid little poison pills. Some had to go into centers just to get off of them. The addiction was not that you CRAVED another pill. I could careless. It's knowing that the anxiety that was sooo bad you couldn't get off the couch or out of the bed would be stopped... by that one little pill. So don't try to tell me or anyone in these situations to take responsibility unless you have been there. Remember you can sit on your wall all you want and judge, until you get older , and that wall crumbles and you find yourself fighting to come off some sort of pill that your doctor put you on to "help you".
Morgan, FYI you were never addicted to Tramadol. What you are describing is dependence, not addiction. Addiction is about craving and compulsively using the drug. The physiological symptoms that appears when the drug is stopped is caused by dependence. It's very important to know the difference so you get the correct treatment. Unfortunately there are a lot of dependent people needlessly in rehabs and on Suboxone or methadone maintenance because they believe they are addicted. In my opinion that just makes things worse.
Dependence can be successfully treated with a slow taper and medications to treat symptoms. Once the symptoms are gone the problem is gone. That is not the case with addiction. With addiction the cravings and need to use continue long after the physical symptoms are gone.
You sir are an idiot. most people that die are either drug addicts or people under medicated so they take more pain meds in different combinations or find alternatives. True pain patients are and will start to commit suicide due to the FDA and DEA
My brother died of an accidental overdose of a prescription that one of his doctor "friends" gave to him because of pain that my brother had from a car accident. Both of my brothers worked (one still does) in the medical industry and reps for companies. It is not uncommon for a doctor to pass something along when they weren't feeling good such as having a cold, flu symptoms, allergies, pain, etc.. Little did my brother know was that his doctor accidently gave him an extremely high dose that is given a cancer patient in their final stages of life. My 34 year old very healthy and successful brother is gone because of such a mistake. So it isn't always the amount, but the dose. The doctors need to be held accountable for weapons that they hold which are medications. They can kill!
No offense, but your story does not jive. Either the doctor was trying to kill your brother, your brother took more than prescribed (either to get high, or to relieve pain), or the story is just false. The LD50 (amount which would kill 50% of people with no tolerance) for prescription pain killers is high enough that NO doctor could 'accidentally' write a script for that amount. For that matter, a healthy 34 year old walking in to a pharmacy with a script big enough to kill with one dose would set off red flags. The pharmacist would call the doctor to make sure the script is real, and would double check with the patient. I am sorry to be blunt, but the reality is most likely the dose was a little bit high, but not unreasonable for bad pain, and your brother took several doses at once. It is very sad, and I am sorry for your loss. I suffer from addiction, and thankfully have been able to keep my PK addiction at bay for 4 years now, but it is just shear luck that I did not end up as your brother.
Dependance is not a simple physical withdrawl. It takes pretty extreme alcoholism to become dependent, most people are simply addicted. Phenylephrine is classic for causing rebound congestion it doesn't mean someone becomes dependent on the drug after taking it regularly for a sinus infection. If you were prescribed drugs in a clinic or er setting that you became addicted to then maybe you should have followed up with your doctor and discussed your problem with them.
You don't know what you are talking about.
Wow, you have not a clue what you are talking about. People can be dependent on pain medication and NOT addicted. These idiotic articles are geared twards ignorant buffoons like you. Well done.
blondie and 'you are clueless' are right.
You people are ignorant, dependance is a medical term not like I have seasonal allergies and am dependent on antihistamines to live a normal life during those months. Dependance medically speaking means that without that medication the person would severe permanent health problems. Steroids are a perfect example. You can pop a 60mg prednisone with absolutely no problem. But you take that daily for a week and you are dependent enough to require weaning from the drug.
SEE THAT'S the problem.
'Dependence' is a term that clinically means addicted.
But for many Chronic Pain Users, they are 'dependant' on their pain killers to have some semblance of a normal life. That's not the same as addiction. They don't abuse their medications, but rely on them to function.
You could say that many Chronic Pain users 'manage' their pain successfully with pain medication.
But as soon as a patient starts to take too much meds, they end up on a slippery slope that can lead to abuse.
Pain meds should NOT be given out without a person seeing a Pain Management Doctor. They have to be told, you can ONLY TAKE the prescribed amout. If you're in too much pain, then you have to wait until you can take your next dosage, and just deal with the pain. Increase in pain meds has to be very small and only on the direction of a Doctor. Having will power to NOT take more than is prescribed is what many people lack.
Kids are walking around with drugs like they are carrying bubble gum. They have no fear of neither the legal nor physical health consequences of drugs. Myteensavers counselors treats teen addicts. Many of them say that they faced very few deterrents when beginning their drug use. The say that their parents did not take an active role in pushing the anti-drug message. They also say home drug testing could have prevented them or detected early drug use. Parents need to realize that they are fueling some of these drug habits with unattended prescriptions.
This epidemic is not coming from our medicine cabinets. Unattended prescriptions can in no way fuel the problem at hand. Individuals can purchase thousands of pills at a time all across the US
People should be allowed to do what they want when they want in regards to their own bodies. The mere existence of Victimless Crimes is such an absurd concept. Unless I am endangering a third party (for example, other drivers on the road, people in public, my family, etc.) then I don't see why the government should be involved. If a man wants to waste away as a heroin addict, let him! We're not obligated to care for him. How do I know? Nobody on this planet is obligated to care for me. When I mess up, I suffer the consequences.
I think it is funny how the most conservative people, who demonize the government's intrusion into our private lives, still find it justifiable to interfere in OUR PRIVATE LIVES!
I agree.. I wish I could just walk into a pharmacy and buy my asthma medicine without having to go see a doctor. How much money do we as a society waste on trying to catch and prosecute drug users and dealers. I definitely think the laws should be greatly relaxed. If somebody wants to ruin their life with drugs they will find a way, legal or otherwise. Why should we have to spend so much time and money trying to stop them.
Then move to mexico. you can buy all the drugs you want without a perscription.
Anyone who has been paying attention for the past 30 years KNOWS that it has NOTHING to do with protecting the public and EVERYTHING to do with politics and profits. If the government gave two turds about us, then cigarettes would be ILLEGAL. They have ZERO health benefits whatsoever. Its a pollutant and people die from second-hand smoke yet it is legal. But people cannot ingest a natural plant called Cannabis that has been around for THOUSANDS OF YEARS helping people with all sorts of ailments. WHY? The reasons are political and profit-driven. ITS ALL BS.
> other drivers on the road, people in public, my family
What percentage of the population never drives, never goes into public, and has no family? Meth heads have killed people to rob them to score their next hit. Which is better, prevent them from becoming meth heads in the first place, or punish them after they've already killed a few innocents first?
We should hang them after they kill someone for drugs then maybe meth heads would think twice about killing people for drugs but then again enforcing new laws seems to be so much easier then enforcing legitimate laws on the books
Thomas, meth-heads don't think twice about ANYTHING. Punishing them after the fact is not going to change anything - we need to PREVENT these things from happening, not react to them. We need to recognize the symptoms of addiction early, and treat the disease (yes, addiction is a disease) before it becomes unmanageable - and all this in addition to regulating the chemicals and supplies used to make methamphetamine, as well as seeking out meth labs and shutting them down.
Docs must learn to say "No" to prescribing chronic narcotics. Many patients are living as "chemical copers" taking meds to avoid the realities of their lives. Docs are perpetuating and supporting that. Learn to say "NO".
Also, Dr. G speaks as if Suboxone is some magic pill that doesn't have risks. It's an opioid. Just like morphine, oxycodone, hydrocodone, hydromorphone, methadone, etc.. The difference is that suboxone is a little longer acting and you're supposed to be in a substance treatment program to get it. Suboxone does have naloxone in it to try to prevent people from crushing it and shooting it up but that doesn't make it "better" than any of the other opioids.
Take your suboxone with a shot of schnapps (as he's suggesting above) and you're just as blue and dead as the guy that took oxycontin with a shot of schnapps. It isn't only combining with alcohol that kills, it's also the combinations prescribed beyond the opioids.
And then the doc lets the patient walk out and drive a car.
You are an idiot!!!!!! Have you even taken Suboxone? I took it for almost six years and not only did it same my marriage and my life but it helped with my chronic back pain. Don't speak on something if you don't have first hand experience, what's the point, your probably a GOP supporter anyway!!!!!!!!!!!!!
"your probably a GOP supporter anyway"---what an idiot.
This is only in small part a fault of Doctors. The over prescription of opiates certainly causes some addiction but the vast majority of addictions dont have any roots in the doctors office. People chalk it up to prescription happy doctors but i can say without question that that is rarely the case.
PharmD, you are an IDIOT and a half. I have been taking life saving narcotics for years now and it has completely changed my life! I deal with debilitating pain 24/7.. pain that would bring you to your freaking knees and without the pain meds , I would be in bed all day long wanting to DIE! I do NOT suffer from depression or any other mental condition. I SIMPLY HAVE PAIN. Because of my narcotic which I take NATURAL SUPPLEMENTS FOR to counteract the effect on my liver ( which is still 100 times safer than all the readily available ALCOHOL that people drink) I can continue to work, volunteer my time, have a happy marriage, and be a productive tax paying member of society.
Screw YOU and your utter ignorance and prejudice. Less than 10% of all pain medication patients abuse their meds.. I think its actually lower than that according to the American Pain Association. So, sit down and shut up.
PharmD is right on. And before anyone wants to inform me that I don't know what I'm talking about, I am a pharmacist AND a recovering addict/alcoholic. Suboxone is not a magic bullet by ANY means, and it certainly is not w/o risks. It's a great tool as part of a comprehensive program including intense counseling/therapy.
Doctors, pharmacists, and all other members of the medical team need to be diligent in managing chronic pain medications. NOBODY is suggesting that people who need them shouldn't receive them, but we have to strike a balance by making sure they are used appropriately and safely. I know, easier said than done - but that doesn't mean we should just give up trying.
For all those on this thread calling RX drug abuse a "victimless crime", keep in mind that many people who abuse/divert/re-sell prescription medications have these medications paid for by Medicaid/Medicare. You ARE aware of how those programs are funded, right?
PharmD is not an "idiot"- those whom call him so obviously have a horse in the race. Those of us who have ACTUAL pharmacology training understand his/her points. After approximately a week, the use of opiates acutally INCREASE a subjects pain sensitivity thus creating a physiologic need for more opiates. This is the phenomenon contributes to increased tolerance to these meds as well. To those people claiming that opiates have saved your life, I'm afraid you are uninformed and I highly encourage you to read actual scholarly articles on pubmed- avoid the general internet. As a practicing internist i feel the statistic of 1.9 million is a gross underestimate. Hydrocodone is the most commonly prescribed drug in the US.... that's really quite shocking if you think about it. More frightening are the scores of geriatric patients I come across who are absolutely dependent- on upwards of 4-6 hydrocodone a day and still in pain as they have been desensitized to the medication. This is not to even mention the epidemic of diversion of these meds.
Superficial articles like this one are not helpful. You can't just look someone in the eye, give them an admonition, and call it a good day's work. On the other hand, categorical rejection of opioids as a tool, among tools, in handling extreme chronic pain situations would be a cruel mistake. Some people really need this stuff and without it cannot function in society. Real pain doctors are always going to seek alternatives. I expect the use of THC will be on the rise. And real pain doctors will go through a detailed protocol of questions with their patients to determine which among them might be addiction prone. The numbers are as high as 1 out 6 The problem for doctors is that patients lie to get the drugs. One key in future will cooperative record keeping that can at least catch the paiients that are using multiple doctors and multiple pharmacies.
I have multipule family members hooked on a variaty of this crap. I witnessed it growing up from a child first hand. And managed to relize addictions run in my family fairly easly. My solution to this was to never start taking it. The only way I will ever take prescription pain meds is if im uncouncious and it is injected in to my bloodstream. Or the onset of a massive pain incurement like being in the hospital. Pain sucks, But not as much as it sucks to watch your entire family go into a pit of dispair. It makes me angry doctors can perscribe crap for patients that dont really, really need it. Thier just addicted to it. I know this is not the case for everyone. But it is the case for more then doctors would like to admit. My best advise is to know your weaknesses, Then not tempt yourself with them.
How many Klonopin scripts do you write off label Sanjay? You need to address benzo and sleeping pill addiction- The great epidemic that's been brushed under the rug.
I bet this celebrity doctor moron writes tons of scripts for anti depressants and anxiety pills. The only beef they have with pain meds is because it actually WORKS and for those of us with CHRONIC PAIN usually just need this one med. Doctors love to put us on anti depressants that dont work for most of us that cause other issue that require more meds and more money lines the doctors pockets. Lets not get confused with the REAL motive of these crap articles.
Are you kidding me? Another doctor who has absolutely no idea of the problem. The TRUE problem is that doctors all think that in order to cure any side effects of medication, you have to use more medication. People take pills just to relieve side effects from taking other pills.
The solution is to get people to solve their problems without medication. I hurt my foot bad a few weeks ago. I went to the store, bought some crutches and Ibuprofen, and took it easy for a while. Now, I can walk up stairs again and have most of the use of my foot back. Some people I know would have gone to the doctor 5 times and have been on 5 different prescriptions by now and they would STILL be in the same position I am. Doctors don't know the meaning of "just take it easy and let it heal itself naturally" anymore.
What a load, are you a doctor, do you work in a doctors office or hospital. People like you talking out of your a** is what makes health care system stuck. You are ready to blame doctors for any problem and would probably happily sue one if you had any excuse.
The problem doesn't lie in the doctors office
Humtake, call me when you're battling cancer, and we'll see how that "take 2 aspirin" is working for you.
Obviously you have wuss pain if two ibuprofen fixed it. Come back to us when you are writhing on the floor with nerve pain from head to toe. Stupid ingrate.
I have had to deal with imbeciles like 'humtake' for years. I have had 30 surgeries since birth dealing with spinal tumors, massive nerve damage, spinal, hip and leg pain. Pain medication is the only reason I can get out of bed and live any sort of life. Yet I have repeatedly had to deal with people like this who will say things like "Well I broke my toe once and I didn't need pain meds, neither do you!". They all have some story about some superficial injury and how they didn't need it, so no one else does either. So far, 100% of the people I know that made comments like that, when confronted with REAL pain, took as many pain killers as possible. Humtake is just another hypocrite.
@ Emmanuel, I agree. I have learned to ignore fools like many you see here. They have the audacity to compare some pathetic injury that will HEAL AND GO AWAY to my debilitating spine issue. They don't even KNOW what pain is. People like that are pathetic judgmental hypocrites. I normally don't wish bad on anyone but for those that try to diminish what I am going through, I absolutely wish they develop a painful condition and get judged the same way.
Personally, I feel it's more of a matter involving money and fame. Do you actually think your garden variety drug user would be settling for the overpriced garbage being offered on the streets when he could be getting pure pharmaceutical grade products from a doctor? The fact of the matter is that nowadays most doctors are extremely aware of patients who may be drug seeking, and are quite conservative in their prescription of narcotics unless perhaps the patient in question is in the terminal stages of cancer. Seriously, getting a doctor to prescribe a Schedule III drug in abusable amounts isn't easy. Unless, of course, you're rich and famous.
Actually this "garbage" you are referring to from the street is actually high grade pharmaceuticals and name brand prescription drugs.
"Actually this "garbage" you are referring to from the street is actually high grade pharmaceuticals and name brand prescription drugs."
You mean like black tar heroin? Oh my, yes. Quality product right there.
My Grandfather was robbed and then beaten in the head with a gun. He fractured his skull and he is blind in his left eye. He was prescribed xanex and percochet. He is now addicted, every child in the family is scared f him because he mumbles when he talks and falls asleep while talking. He looks nothing like he used to. All because of legal drugs.....
Because the beating to the head obviously had nothing to do with it.
"Percochet"? Is that some kind of French pain reliever? Is the "t" silent?
Pharmaceutical Companies KNOW they are Producing Far More NARCOTICS than any LEGITIMATE Need Requires. But – They keep making and selling them. Doctors KNOW that the QUART JARS of NARCOTICS a Patient like Anna Nicole or Micheal Jackson (According to his SONGS his Drug of Choice was Demerol ) are NOT worth their MILLION DOLLAR 'FEES' – Drug Pushers Deluxe
And how many die each year from the most dangerous – and legal – drug of all...Cigarettes?
Or alcohol, which is addictive and mood-altering and available over the counter everywhere.
Cigarettes don't ruin your life over the course of a few months. If a smoker doesn't have the money for a new pack they won't break into your house to get a fix. As harmful as long term tobacco use can be it pales in comparison to the life destroying effects of opiate addiction.
This was a boring article that gave out ZERO information that is not readily availiable to the massess. Sorry, Doc. Yes, you're cute, but you can do better. Yawn.
The medical community is now worrying about addictions to drugs. They have known about the addictive properties of these medicines for a very long time. They are only too willing to prescribe these drugs and then to give refills. Things have to change and doctors need to take some responsibility. Dr. Gupta is a little late on this one.
Nothing will change until the government stops treating it as a criminal issue and figures out its a medical issue once someone is hooked
Create a world, a just economic system, and create accountability for those who destroy the well being of the world we depend on for food, water and sustenance. Create a country that has a promising future and only elect leaders who are upstanding and do as they promise and don't waste money they steal from us. Create a world where people aren't pitted against each other in the name of achievement and where community giving and involvement is recognized the way over paid athletes are and I promise you, the amount of people who turn to turn drugs to fill an emptiness in their life, will diminish....
This whole notion of drug use as a tool to "fill and empty void in your life" is beyond naive. Emotional problems to contribute to drug abuse but there is a wide range of other reasons why people begin to take these drugs.
Oh yes, thats the solution, blame doctors for patients bad behavior. Blame doctors because they didn't sit down and spend 4 hours explaining how a drug works and every possible complication that could arise from using it even if those chances are 1 in a million. Doctors have a responsibility to help patients, if a patient says they are in pain then its the doctors responsibility to treat that pain or send them to another doctor that will.
And if the doctor says, here this is a safe drug this how you take it. You do as it's prescribed trusting the doctor and ending up in a bad situation then the patient is STILL to blame? That's like getting surgery and the doctor taking out the wrong thing and blaming the patient. Sure there ARE people that abuse prescription , most.. just want off the stuff that their doctor put them on. Myself I was hooked on Tramadol My step-father and mother both were put on ambvient. My husband was but on Topomax. While he never became addicted to it, the week he took it,it put him in such a state of panic that he couldn't hardly handle it. You know what my doctor said after I FINALLY kicked tramadol? Well I'll put you on Cymbalta instead. Looked it up, sure enough it caused a lot of the same problems. Yeah... right.
To several of the comments: All absolutes are wrong.
This is no new news. I know people who abuse Methadone, Suboxone and Subutex and all are supposed to help with addiction...
Dr. Gupta is a TV doctor. Some of what he says is true but it's a lot more complex issue than stated here. Dr. Gupta is about as likely to be in a clinic as "Dr. Phil" is taking patients.
Reblogged this on NosyAss®.com and commented:
Narcotic addiction is common ,comes in many degrees of pathology, suboxone is "just" another narcotic ,but it is much safer than other opiates. whether an addict takes 3 or 300 pills ,,no diferrence, and blocks all other opiates that an addict will crave and take for @ 36-48 hr.. helps an addict regain some control over the use of opiates.. not for everyone but in my own clinical experience,, this drug has helped to save many lives for that i am thankful. For those with inadequate desire to get strait it just doesnt work doc.. not true , they just cant help but relapse they need inpt detox.
I know tons of people who are dependent to anti-deppressants. Guess the concern for pharmaceutical addiction stops there....
This addiction phenomenon is no accident. The inventors of these drugs have to know that these chemicals are unsafe for human consumption. The United States likes to play the "oooopsss, I'm sorry, I didn't know you would die" role so they can find another cause to supposed dump money into for their real causes. Cigarettes, alcohol, drugs on the street... it's all a part of the plan of Eugenics. People are so deaf, dumb and blind. All they care about is the right here and the right now. Every body knows that mixing drugs of any kind (medication) or not is a dangerous combination. People just like to go close enough to the edge because they think they are the only one's who won't fall.
You forgot the part about the Illuminati. Paranoid conspiracy fail.
30,000 people die a year? Not to sound callous, but give me a break.
How many millions die each year from cigarettes? Or alcohol? I don't see doctors or the DEA doing anything about that.
I can go get a gallon of vodka and a carton of cigarettes without a second glance. But take opiates or marijuana relationally and you face the hell that is the US criminal justice system.
Steven is 100% spot on. 30,000 is NOTHING and how many of them are people who took it and did NOT have a prescription!? Give me a break with this crap! If they really cared, cigarettes would be BANNED because MILLIONS die from that each freaking year!!!!!!!!!!!!!!!!!
Phamaceutical Cartels of America distribute their drugs to every pharmacy in every local nationwide. The war on drugs should include them because the access they have is where the real money is and the real dangers regarding drugs are at. I know lots of people that are hooked on their drugs and the difference between The American Cartels and The South of the Border Cartels is INSURANCE COMPANIES. If you have insurance, then you have access to the American Drug Cartels and if you don't ... its south of the border for you.
Yes, there are addicts. Yes, there are addicts trying to and sometimes duping doctors for opioid pain meds when they don't need them. Yes, there are bad docs and pill mills. But there are many more non-addicted patients with chronic pain who go to good doctors to get appropriate opioid presccriptions for their pain and who use the meds properly. With the aging of the population, chronic pain will become more of a problem....and it is a huge problem already. People who don't have adequate pain management will sometimes resort to the streets or pill mills, alcohol or suicide in extreme cases if legitimate pain management is denied them or is not available. Focusing on the liars and the addicts and bad docs more than the patients whose qualit of life is ruined due to an inordinate degree of fear of addiction and addicts is a natiuonal disgrace. Criminals and addicts (not necessarily the same) will always figure out how to abuse the system....We are abusing those good people who are in real, chronic pain by creating the impression that there are fewer of them than persons without pain addicted to prescription pain medications. The DSM V committee on substance use disorders is struggling to clarify this misconception by clearer diagnostic criteria so that true properly managed pain patients are not confused with addicts and misdiagnosed and denied their needed medications. The current atmosphere and emphasis on the opioid addicts makes it all the harder for those in true pain to get propert treatment which may include opioids. Physical dependence (suffering withdrawal symptoms if a drug is severely curtailed or stopped abruptly is not a sufficient condition to diagnose addiction. Go to the ASAM or American Academy of Pain Medicine or American Pain Society websites and look at the Liaison Committee definitions of addictionk dependence, etc which have been adopted by many organizations and states to get a bit more educated on these distinctions. .
Diane, thank you for a great post
dr gupta states
Almost half of those addicted to painkillers – 49% – were able to reduce their drug abuse when taking Suboxone for at least 12 weeks. The drug works by reducing withdrawal symptoms and relieving cravings.
suboxone ( buprenorphine and naloxone) ) is an opiate painkiller.........
this statement is like saying ' almost half of the people addicted to vodka were able to reduce their vodka use by using gin'
It's amazing how many people - some physicians included!! - do not understand how buprenorphine works. I filled a prescription on Monday for a young guy who has literally been taking it since it was approved for the market - 32mg a day, in his case there has never even been an attempt to wean/reduce the dose. And he'll tell tell anyone w/in earshot how wonderful his life has been since his addiction was cured.
I hate opiates. I do not like the way they make me feel and I try to take as little as possible for my disk degeneration. I have to get cortisone shots in my nurve canal.
I took A tramadole once and thought I was dying. I hate pain meds- the constipation, sick feeling, and depression the next day-horrible. I liked nurontin but my back was so stiff I could barely walk and I was bending backwards at night while sleeping-weird. My doctor mentioned this new drug. I said no thanks. He told me it was a different kind of opiate.
@Mike, clearly you don't understand how Suboxone works either. You have no clue. Suboxone, like methadone, is a maintenance medication, not a cure. It only works to treat addiction as long as the patient takes it. When they stop taking it the majority relapse (as the article above states) so to remain in recovery most have to remain on medication. No attempts are made to wean people off Suboxone because doing so leads to relapse and misery. Clearly you don't understand that. Fortunately the doctors do.
J. Miller, thanks - but I'll stick with what I learned in six years of pharmacy school, plus the 8-hour Suboxone training program approved by the American Society of Addiction Medicine that I audited. I have a pretty good understanding of how it works, so I hope you don't mind if I ignore your feeble attempt at explaining it.
a drug for another drug- one addictive drug to the next- heroin to mentadone; vicodin to subozone?
one successful process to get people off pain meds has to do with replenishing the endorphins which the brain creates ut goes dormant when pain meds do the work-Nutrition use massive doses of b vitamins , e, a, c, amino com-plexes- it is working on those addicted like rock band members. check it out -nutrition will solve the craving and withdrawal problems better than another drug like suboxone.
why dont we hear abt that type treatment from dr gupta?
i do believe addiction within then net is becoming if not bigger then drugs/medication.
After reading the story and comments I think there is a huge misunderstanding about most addictions to pain medication. The people who are actually addicted to it are not taking it to relieve pain – they are taking it to get a high. Vicodin and Oxycontin are used and abused for FUN – not relieving pain. Many doctors are addicts too – they know the right dose to take for that high. Basically, a doctor does not want to prescribe too much at a time for a patient because one might start using it for the high.
I agree that the abusers are using it to get high. The vast majority of pain patients who take opioid medications properly prescribed do not get a buzz or high, but get some part of their pain relieved.
First off, Suboxone is a joke. That's like weening a alcoholic off Jack Daniels by giving them beer. You are only trading one addiction for another.
Second, the most dangerous component of painkillers is NOT the opioid medication, but the acetaminophen (Tylenol) which can quickly destroy one's liver. Tylenol still remains on the shelf regardless of its deadliness. If a person has a life-long chronic issue with pain and has exhausted all other options (most quack "cures", what difference does it make if these people have a dependence on pain killers? Why should they spend their lives in agony because some idiot Doctor doesn't want to get flagged by the ridiculous actions of the DEA? Until we outlaw the most dangerous drug, alcohol, all these moves to strictly regulate painkillers is nothing short of bureaucratic hypocrisy.
This article is a perfect example of the mindless adherence of medical people to whatever they are told at the time. The Prevailing Wisdom changes with time. They used to put leeches on you to suck the bad blood out of your system. If your doctor suggested that now, you'd report him to the authorities. Your blood pressure, cholesterol, and bodyweight all have to conform to the latest estimation of the medical establishment, which changes all the time. Eat, drink, and be merry, for some day you will surely die.
Actually, leeches are still used in even modern medicine, although admittedly rarely.
I wonder why people insult Pharmd when he is a competent voice. if you are a patient listen to expert advice. If you think there is a problem get a second expert opinion. All this yelling is really a abuse of freedom of expression. Ignorance is left to run amok.
Let the Pharmd write about drugs or a pharmacologist.
We are all hopelessly addicted to food, water and sleep . .
"As a doctor, I will look my patients in the eye every time I hand them a prescription to tell them the concerns about the pills they will take." " I will remind them that they could become addicted, and they could die. That is our jobs as doctors, and it is one way to save thousands of lives." Dr. Gupta makes me laugh! Instead of this condescending phoney baloney, Dr. Gupta should scrutinize his patients' real need for the medication and work out a plan to enable them to wean off the medication.
Articles like this do a disservice to legitimate chronic pain sufferers. I'll bet Gupta never lay on the couch crying from herniated disks in his back, or he'd be writing a different article-about the ridiculous hoops real pain patients have to jump thru to get relief.
1.9 MILLION ?? ... LOOK AGAIN.. It is more like 19.MILLION.
AS A PHARMACIST I SEE IT EVERFY DAY AGE 18 TO 88.... HOOKED ON LORTAB, OXYCOTIN, XANAX.TRAMADOL TAKING .... ! 6 TO 8 tablets EVERY DAY & CAN NOT LIVE WITH OUT IT..
DR SHOPPING PHARMACY HOPPING...
suboxone....helps but many stay on it to years!!..
ALCOHOL kills... Durgs kill...
each ADDICT must want help....
or die or kill someone else !
DOCTORS ARE TO BLAME TOO......
SOME HAN OUT RX's just to get rid of the patient!
DOLLARS & ETHICS...
THE DOLLARS SEEM TO WIN..
When it comes down to it, people must live or die with the choices they make regarding their bodies. Hopefully they get educated on the problems of painkillers and all other medicines, but I do not like the idea of the government telling me what I can do or not do with my own body . . .
Dr Gupta, I do appreciate that you made some distinction between the addicts and people that use painkillers everyday without harmful side effects. That is one thing I do not usually see in articles. I do, however, think these timely "jump on the band wagon" articles make it hard for a chronic pain patient and also for the doctors that have to deal with patients. Everybody gets scared and more of these articles will just make people more scared. Please, stop scaring people.
You may think I am talking about it being scary from a standpoint of not getting prescribed the medication I need, but that is only half the problem. Any doctor (with the exception of one very rude and out of touch ER doctor) can look at my records and know that I spend a great deal of time in some pretty bad pain, but my next door neighbor or co-workers just might have a different view of me if they keep reading about all these addicts taking pills.
I have always tried to treat myself as a whole patient with different exercises, supplements and yes I simply can't go without a strong pain reliever, which just happens to be a narcotic. I don't want a stronger one because I am sensitive to them, and I don't abuse them . For the record I do know people abuse them A LOT, but that is their problem, these articles make it mine and it just isn't fair.
Remember "Guns don't kill people".. same goes for drugs. I am not saying not to counsel your patients, because, of course, that is proper. But please, stop counseling the world.
I have worked as a registered nurse for twenty-one years. I have worked with thousands of patients that need or take prescription pain medications and the one consistency among them is the desire not to take pain medication, not to be come dependent on pain medication and to get off them as soon as possible.
I do not believe that 1.9 million people are “addicted to prescription pain medications. Please doctor let me know when you have spoken to the 1.9 million “addicts”. I believe you will find people do not want to take pain medication for any longer than needed.
Lori, I appreciate you posting. This is a so true statement. As a patient I just want the drug that helps ( I am scared to death of all the new drugs, but I am weird that way. I have so many side effects it's pathetic) and I have really struggled to find other things to help. I don't even take half the medicines I am prescribed, but get them filled anyway so if I need them I have them.
When I first became a "pain patient" I squirmed because I thought this just can't be me. I have to find a way to fix this. I still try to fix it. I will never give up believing that there are answers. My recent binge was a massive intake of orange juice..lol.. but my body craved it. The sad part is, I can count on one hand the really wonderful days I have had in the last two years, but thank goodness I do have at least good days.
Also, Thank God for medicines that do actually help because one my conditions is debilitating, it was robbing my life until I was prescribed pain medicines. Before opiates I took Ibuprofen, which is a WONDERFUL drug, but unfortunately will cause bleeding and it happened to me. I am allowed Ibuprofen one time a month as long as my ulcer isn't active. That is the only day I can say I can get close to pain free.
Another thing people don't know about real painful conditions. A pain level of Zero in not unattainable. I think that is where doctors do not counsel patients enough and the patient may add to their dosage. I know people that will take their medicine and say if that don't work I will take something else in an hour. I always warn them to not do that, but they don't seem to know the difference in the body overload.
oops.. I mistyped. .I mean to say a pain level of zero is UNATTAINABLE.
This is the first mainstream media article I've seen that mentions Suboxone even though I've written Dr Gupta, Dr Oz and others to bring awareness that Suboxone is an excellent replacement for addictive painkillers for pain management. I was on Suboxone for a couple of years for pain management and it worked very well but then had to switch to VA healthcare and they won't use Suboxone for pain management even though the link below makes clear that the DEA allows doctors to prescribe it for pain management. I didn't build up a tolerance with Suboxone and it did not impair me in any way because Suboxone does not affect dopamine. You only need a special license to prescribe it for dependence/addiction but not pain management. Letter from DEA: http://www.naabt.org/links/DEA_Bup_for_pain_letter.pdf.
I iAM 100% va tdiu and was recently (0215120) given a fee based letter to see an outside private pain clinic, since I live in Idaho and the closest VA pain clinic is in Seattle. It also is difficult for me to travell due to disabilities. Anyway the pain doc gave me 2 weeks prescription which the Spokane VA pharmacy filled at no charge for me. I've been on it a week, but the side effects bother me (insomnia, headach etc) and the relief from 2 88mg/2m a day.
This is a travesty. I got laid off and eventually lost my COBRA helath insurance. I have chronic back pain and I take my pain medicine as directed and actually some days I don't need as much as others and usually end up with a surplus every month. When I lost my COBRA, I had to find a community doctor to prescribe me my pain meds and diabetes meds. I was treated like a junkie and like a criminal. Even though I presented my records from my last doctor including a back specialist listing my maladies including the meds I was taking, I was told by a doctor that she didn't feel comfortable prescribing me my pain meds. HUH??? So now, I am in pain lying in bed and have been going through horrible withdrawals because I have been on pain meds for 4 years. I agree some people abuse them, but I am one of those who actually need it to be able to function and get around. Terrible...
Thanks to you people working every day and paying taxes- all kinds of people on mental health disability see pain doctors for opiates and show up to psych apts. and get psych meds so that they show up as being in mental health treatment at the social security dept. THEn they continue to get those ssi checks and pay for more drugs and pot or whatever else. Sure, its only about 850. a month here in Ca. but you provide section 8, thats about 200 a month rent for them and you subsidize the rest at 800 – 1800 a month. The only people who really need disability for mental health are schizophrenics and people with developmental dis. Everyone else can work and it would make them better.
But thanks all you working stiffs for the job and the cash!!!!
Your statement is bordering on ignorant. Mental health doctors do NOT prescribe pain medicine to their patients.
No Lolita, his comment does not border on ignorant. It IS ignorant, beyond ignorant. In fact it's plain dumb.
Somebody should invent a drug with analgesic and anxiolytic properties (among other medical benefits) that's not physically addictive and that's also incapable of causing a fatal overdose. Oh wait, someone did. It's called cannabis. Our government made it illegal. Nice work, geniuses.
I am a pain patient. I can't smoke pot. I tried it when I was young and all I did was sleep..lol.. BUT, if it were to become legalized maybe there would be some form I could take without sleeping. I hear that it helps a great deal. Surely we are getting close to being able to legalize this drug. SURELY
@ Roger: Unfortunately, it hass been found that the only thing that really works for pain derives from Morphine, whether it be codeine or other opioids. Herroin was once used for pain also. Any related to Morphine is addictive unfotunately. For those that abuse these medicines, in these hectic times we live in, it offers a different kind of relief. This supposed eopidemic has only been around for the last twenty years, it basically what Cocaine was in the 80's and TV and movies glorify their use by showing rich older women chomping down on Xanax to survive their day, much like the TV and movies of the 70's showed people smoking pot for the same reason. if you remember the show House, he was hooked on Vicodins, but he was a portrayed as a loveable character...
@Loita: Really? Lyrica has never been found to work for pain? Gabapentin? NSAIDs? Can you direct me to the studies backing this up>
Because of all the hoopla lately about pain killers, their effects etc. someone who truly needs them can't get them because the docs are running scared. Society's label that a person on pain meds is addicted isn't fair. They may be dependent, but not addicted. I was precribed a trial of Suboxone for pain management and all the postings I've chatted with say I must be a recovering addict. Give it a rest
What's also amazing is the amount of drub abuse that occurs - all drugs, especially the dangerous ones that can easily cause death, is how infrequently people actually die doing very dangerous things! It's amazing how the will to survive leads most people to regulate their use of dangerous substances! Of, course, by the rules of probability some people will die.