The statistics paint a startling picture. Enough painkillers are prescribed for every adult in America to be medicated around the clock for three weeks. 80% of all opioid painkillers are produced in the US, despite the country having 5% of the world’s population. No other developed nation, aside from Canada, has a problem with prescription drugs on anything near the same scale. How did we get here?
Anyone who works at an addiction treatment center can tell you that addicts often don’t look like most people expect. The average American understandably assumes that people become addicts because of things like untreated mental illness, poverty, or simply falling in with the wrong crowd. But if you’ve been paying attention to the news recently, you’ll know that addiction today often stems from a much more innocuous place.
The opioid crisis has become a buzzword for politicians and activists. The term opioid includes everything from light painkillers to morphine to fentanyl (which is 100 times stronger). The focus hasn’t been on illicit use of these drugs, in pharmaceutical or street form. Many opioid addicts turn to heroin, which is itself an opioid, but the problem starts in doctors’ offices and hospitals, with the perfectly legal prescription of painkillers.
The problem seems to have begun in response to another crisis: the undertreatment of pain. Up until the ‘90s, doctors in the US were reluctant to prescribe painkillers, in large part due to the fact that these drugs could be addictive. For this reason, it was common that people in the last stages of cancer, going through extreme suffering, were not even given opioids.
The undertreatment of pain had to be addressed. Unfortunately, at the forefront of the countermovement were the big pharmaceutical companies. Instead of encouraging moderate prescription of opioid painkillers when necessary, they marketed their products as non-addictive solutions that had no downsides.
Twenty years on, their claims have been resoundingly proven false, but it’s a little late. Doctors are still prescribing opioids at an alarming rate, and more and more people are becoming addicted.
When we think about addiction, we tend to assume that something “went wrong.” Bad circumstances led people to abuse drugs and alcohol. It’s not that everyone blames the patients (although too many do), but the assumption is that someone living a happy life, with no major financial or societal problems will not abuse drugs.
But in any treatment center you’ll find patients for whom nothing “went wrong.” However, they were prescribed opioids to deal with pain that would have been manageable in other ways, and the sheer addictiveness of the pills got them there.
I’m not just talking about those who come in with an addiction to painkillers. As many as 75% of people addicted to heroin in the twenty-first century initially became addicted to opioid painkillers. Eventually, painkillers became more difficult to get, too expensive, or just not strong enough, and heroin simply became a more practical solution.
One major difficulty in dealing with the opioid crisis is that opioids themselves are not inherently problematic. For some people suffering from chronic pain, life without them would be unbearable. For people suffering from various forms of cancer, opioids can ensure they don’t have to spend their last few months in excruciating pain.
However, for most people, alternative solutions to pain are available. Physiotherapy is often a much better long term solution than painkillers. Hypnosis, mindfulness, and other forms of therapy can help people with treatment-resistant chronic pain to manage it mentally. The mind is incredibly powerful, and those who master mindfulness techniques or respond positively to hypnotherapy can live very happy lives without having to numb out the pain.
To many Americans, this will sound unrealistic, but when we take a look outside this continent, we find that painkillers are the “alternative solution.” They’re used only when other options don’t work, which is why addiction to prescription drugs does not become an epidemic. There are opioid addicts around the world, but the opioid crisis is uniquely North American.
The problem for many Americans is that access to alternative resources can be limited. In some areas, this is simply because people are not aware that there are alternatives. In others, such as rural areas, these resources don’t exist.
Solving the problem on a national scale will take time, as well as a lot of politicking. However, by being aware of the problem, we can help make sure that we don’t fall victim to it, and that our loved ones know there are other options.
Prescribed painkillers may be legal, but that doesn’t mean they won’t do you harm. Only turn to them when they’re absolutely necessary – they should be the “alternative” option.
Dr. Nancy Irwin is co-author of “Breaking Through, Stories of Hope and Recovery” and a Primary Therapist at Seasons in Malibu World Class Addiction and Mental Health Treatment Center