Study Calls Painkillers ‘Gateway’ to Heroin Use

Study Calls Painkillers ‘Gateway’ to Heroin Use

One of the nation’s largest drug screening companies has released a new report claiming there is “concrete evidence” linking prescription painkillers with the rising use of heroin.

In a study of drug tests collected from 171,061 chronic pain patients, Ameritox detected heroin in 2,206 of the patients’ urine samples. Although that is just 1.3% of the total number of pain patients studied – it is greater than the 0.3% in the general population that use heroin. Ameritox said the data was a sign that “chronic pain patients are using heroin with painkillers” and “prescription opioids are the new gateway to heroin abuse.”

The full report, which can be found here, is being presented at PAINWeek in Las Vegas, a national conference attended by 2,000 practitioners in the field of pain management.

800px-Injecting_HeroinAccording to the Substance Abuse and Mental Health Services Administration, heroin use has nearly doubled in United States. The number of people reporting that they have used heroin rose from 373,000 people in 2007 to 620,000 people in 2011.

“Part of the story of heroin’s resurgence is how it is manifesting itself in the lives of chronic pain patients, and that makes this epidemic unique from heroin scourges of the past,” the Ameritox report states. “More and more opioid users are turning to heroin, most often when the prescriptions become difficult to obtain and users find that heroin is easier and cheaper to get.”

The study – and Ameritox’s presentation and interpretation of the results – came under sharp criticism from Mark Collen, a pain patient and longtime critic of the drug testing industry.

“If this graphical display is what Ameritox is calling ‘a research report that provides concrete evidence linking prescription drug abuse to heroin abuse,’ then I’d have to say that the people at Ameritox may not understand the meaning of the words ‘science,’ ‘research report,’ or ‘concrete evidence.’  I could imagine a junior high school student coming up with a similar conclusion based on their graphics but of course he would fail, much like Ameritox has at their attempt at ‘science.’” Collen wrote in an email to National Pain Report.

Other key findings in the Ameritox study:

  • 66% of heroin users used both heroin and a prescription painkillers in the last month
  • 56% of the positive heroin samples did not contain a prescribed painkiller
  • 20% of heroin users tested positive for a non-prescribed sedative such as Xanax or Valium.

“This is challenging (report) to respond to, because it’s a bunch of thrown-together facts without any discussion to hold them together and get them to a meaningful conclusion,” said Bob Twillman, PhD, Deputy Executive Director of the American Academy of Pain Management.

“Some of it is not surprising, especially the parts that indicate that people bounce back and forth between prescription opioids and heroin — after all, those who use these drugs for purposes of abuse get the same effects from both sources. I suspect that some will use prescription drugs whenever they can get them because, if swallowed, they expose the individual to lower risk of complications like hepatitis and HIV, but when their supply runs out, they will turn to heroin if they can find it.”

Another recent study also found that many heroin users are attracted to the drug not only for the “high” that it brings, but because it’s cheaper and easier to get than prescription painkillers. Researchers said many drug abusers started with prescription opioids and then switched to heroin when the painkillers became too expensive.

The average cost for a single dose of heroin is $10, while an 80mg dose of oxycodone costs $80 on the black market.

But Twillman believes the overprescribing of opioids – not just its cost – may be what’s driving the increase in heroin use.

“I do think that it’s entirely possible that the sharp increase in opioid prescribing after about 1995 has contributed to this problem by exposing more people with a vulnerability to substance abuse/addiction to opioids than were exposed in the past,” Twillman said in an email to National Pain Report.

“The conclusion is still the same—we need to be judicious in our prescribing; very closely monitor people for whom we prescribe to intervene as soon as there’s an indication that they may have an issue; and make maximum use of non-opioid medications and non-medication options in treating chronic pain. Opioids need to be part of our toolbox to treat pain, but they shouldn’t be the only tool.”

Authored by: Pat Anson, Editor

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Melahn

My dad had neuro. surgery twice, he’s had multiple steroid injections for pain he’s also done several stents in physical therapy. My mom’s had neck surgery and physical therapy as well. It wasn’t until my dad had a shoulder replacement and my mom made a visit to the same ortho. surgeon for hip pain did she receive a referral to an anesthesiologist for pain management. It has been so great for her. He’s given her 2 or 3 injections for hip lumbar pain and she goes one more time for sciatic pain. She’s encouraged for the first time in years. She’s actually walking at a much increased speed and feeling good about it, no pain in her hips! My dad is going to see him soon in hopes of getting relief from arthritic pain. It seems as though many patients suffering from chronic pain could benefit from seeing a “true” pain management physician…an anesthesiologist. I personally know 2 people that have turned to heroin because they could no longer get their prescribed opiates. One was prescribed pain medicine and became addicted, the other was addicted until he bought heroin and overdosed…I’m not sure what led to his addiction. If we’re in true pain then we shouldn’t become addicted, but…there’s a “fine line” between taking the medicine and feeling relief vs euphoria. We need to remember that it’s time to pause and reflect if we feel euphoria because that’s the moment that starts it all. I agree that if physicians are going to prescribe opiates for chronic pain they MUST know what they’re doing, know their patients, monitor them closely and know of all opiate alternatives. Not just familiarize themselves with alternate therapies, but study and believe in them. It may mean turning patients away, but I’d like to think of it as re-directing them towards a much better solution. It would may be better than what’s going on currently…just turning patients away without facilitating any sort of transition at all. Regardless of how I feel about the article, I believe; in many cases there are alternatives to opiates for chronic pain relief. Seems it’s been left up to the ones suffering to take responsibility for finding treatment. My hope is for folks to open their minds to the alternatives and at least try. I constantly remind myself I need to give my brain much more credit than I’m so inclined. Someone mentioned distraction, I know it works. Doctor’s do too…just look at Lamaze. Just in case I didn’t make it clear, I am grateful beyond words for prescription opioids for acute and chronic pain relief. I completely know there are those who’ll unfortunately and legitimately be dependent on them for life. When I talk about alternatives, I’m referring to patients with a clinical “picture” that could possibly qualify them for an opiate free future.

Amy Price

I have been sober with the help of methadone for 21 years. I was also on Dilaudid for chronic back pain. My husband died recently, and I had decided to try and get off of methadone and move out of state. Bad idea, after going down too rapidly, I asked the clinic to go up, and found that aside from a one time increase of 5 mg, I would have to relinquish my take outs in order to increase my dose anymore. It took three weeks to just get the 5 mg. Meanwhile, I used my Dilaudid up too quickly , to compensate and realizing my error , promptly called my Dr. of 8 years to tell her. Well, she cut off my Dilaudid completely, and refused to even discuss it with me. Because of the DEA’s epic failure in the so called “war on drugs” , they began to focus on prescribed meds, to justify their jobs, starting with the oxycontin 10 years ago. This witch hunt has made Pharmacists and Doctors so paranoid , people are losing their pain meds at the speed of light. Doctors are afraid of getting sued, but what about patients who end up blowing their brains out , or going to the streets for pain relief. I have learned that my 20 years of “walking the walk” had earned me nothing. At the clinic, I’m treated with no more consideration than any hump off of the street. As for Doctors, you can’t get anything done, and believe me folks we are on our own. I stepped off of the yellow brick road ONCE and was totally shut off. That’s what my honesty got me. Welcome to the modern world, where half measures and mediocrity are the new standards. When my Dr. said ” I’m sorry it has to be this way” I replied “no you’re not!” You are more than happy to scrape me off your plate, along with anyone else who needs narcotics ” Trust me, they all want us to GO AWAY. My Dr. demonstrated that when the going gets tough, the tough go a missing! As long as it’s not out of their comfort zone, you might be OK. Anything stronger than Percocet, I wish you good luck! Personally, I keep heroin on hand for when the pain gets too bad. We must do so much, because they do so little!

Johnna Stahl

Melody said: “The rise in heroin use is due to the fact that the drug addicts are having to resort to a cheaper drug because the oxy’s are now extremely hard to get… Legitimate drug users with chronic pain do not use heroin, period.”

It’s funny, even with my high level of skepticism, I believed the articles I read that indicated pain patients were switching to heroin because of the lack of access for opioids. Partly because I know how desperate it feels to be without adequate pain relief. And partly because the latter is true — lack of access to medication — as I’ve read on many a comment section. But I’ve never read where a pain patient actually admitted to using heroin…

The tragic victims of this epidemic of overdoses appear to mostly be those who suffer from addiction, which is not the majority of pain patients. And while I think it’s important to shine a light on the issue of addiction, if we’re only discussing pain patients, then we’re not talking about “epidemic” proportions when we discuss addiction.

Perhaps part of the hysteria has to do with the high level of drug abuse found in the middle class, and that some of those who are prescribed pain medication aren’t — as Melody described — legitimate pain patients.

Unfortunately, it’s too late — many doctors have already decided that those who suffer from non-malignant chronic pain don’t deserve the strength of relief that can be found in opioids. (At least not for long-term treatment — which is when patients really need it.)

Melody

I would have to say this is the most ignorant article I have ever read. The rise in heroin use is due to the fact that the drug addicts are having to resort to a cheaper drug because the oxy’s are now extremely hard to get. Anyone with two brain cells to rub together should have known this was going to happen. If drug addicts can’t get what they were using they will resort to other substances. Legitimate drug users with chronic pain do not use heroin, period.

J L

Thank you Kurt for so eloquently making the point that when pain management patients are consistently failed by our alleged treatment system, they might seek relief from illicit forms of narcotics rather than suffer withdrawals. Heroin (which is prescribed in Europe) is no different in it’s effects from hydromorphone, oxycodone, morphine or any other “legitimate” opioid or opiate. What can make heroin dangerous to opioid/opiate tolerant patients are impurities and the inability to tell in advance the strength or weakness of a particular purchase. Pain patients seldom experience narcotic highs from any legal or illegal narcotic because they are treating pain and have established tolerances. This alleged study smells like a butt load of crap that Ameritox dashed together to prove to insurers and providers that their services are worth funding but save lives, gosh darnit! I’m sure once their methodology sees the light of day and scientific review it won’t survive peer review and will never see the inside of a legitimate medical journal. Unfortunately, like most bad research with sensational findings, it’ll haunt the pain management community like untreated syphilis.

Johnna Stahl

Reta said: My Dr. took me off Oxecotin and has me on Morphine. In between I have Oxycodone with Tylonal. So far my pain is better. I don ‘know the results of the Morphine. I have been told it causes constapition? What about your chronic pain have you tried Morphine?

I have taken all the medications you’ve mentioned, including morphine, and the worst side effect from morphine (and oxycodone) was the nausea. The only anti-nausea medication that helped was too expensive (tiered so that co-payments were only available to cancer patients).

Many pain patients suffer from constipation, but I never had that problem. If you don’t have a problem with constipation when you take oxycodone (Oxycontin is a brand name for oxycodone), morphine shouldn’t be that much different.

Johnna Stahl

Jaswars: Showing up for your monthly appointment only to find a DEA raid in progress is pretty bad. Traumatizing, really. Kinda like getting a call the day of a monthly appointment, notifying you that your doctor of 8 years has suddenly passed away.

Was there an alternate plan in place? Another doctor willing to take on hundreds of pain patients, or are they now on their own? What do you think?

Turns out a small, select group of my previous doctor’s patients were successfully referred to other doctors. The rest of us were left on the curb.

I have found that, no matter what issue we’re talking about, it’s all about who you know.

My Dr. took me off Oxecotin and has me on Morphine. In between I have Oxycodone with Tylonal.
So far my pain is better.
I don ‘know the results of the Morphine. I have been told it causes constapition?
What about your chronic pain have you tried Morphine?

Jaswars

@ Johnna ,

Oh my god you nailed it !!! I would like to add one more item your list of “What could go wrong this time” as this really happened to me;

You open the office door to your Pain Management Clinic only to be greeted by a bunch of yellow jackets with the words “DEA” written on the back of them as they are conducting a raid on the clinic and you say, “Is this a bad time?”

Johnna Stahl

Jaswars said: “…as I can tell you firsthand I loathe going to my doctor to pick up my prescription every month, it is a major hassle in every way to get the proper treatment without any harassment, embarrassment, and ridicule by any health care professional.”

You know that increase of anxiety and dread you feel as a pain patient when it’s that time of month again? Oh, man, another appointment with your pain “specialist”…

You begin by re-confirming your appointment, just in case your doctor had a change of plans within the last month. (Else you could end up in the waiting room all day for naught because your doctor never returned from an emergency.) You spend lots of time reviewing your checklist to prepare for the inevitability of something going wrong as you spend your way through the health care system yet again.

Got your daily medication charts? Any insurance forms that need to be filled out by the doctor? Your list of monthly questions? Problems with last month’s prescriptions? (And don’t forget your wallet.)

What will go wrong this time? Will the doctor tell you he can’t prescribe one of your medications anymore? Will the nurse be in a bad mood and uninterested in double-checking the prescriptions illegibly written out by the doctor? If the pharmacist has a question, will the doctor’s office be shut down for lunch (or just not answer the phone)? Will the pharmacist or your insurance carrier refuse to fill or pay for your medications?

As the day approaches, your anxiety and fear levels increase… After all, preparation doesn’t help with every situation; especially when, as a patient, you have as much power as a feather in the wind. Everyone else tells you what to do, and few treatment decisions are your own. You have no control — over the amount of relief that you’re allowed to have and (way too often) your pain levels.

After an exhausting day dealing with the health care system, you finally make it home. You immediately do your own count of each prescription, as there are usually errors. Sometimes you can do something about a shortage, but most times you just have to adjust your dosage accordingly. If you are lucky enough to have an overage, you put it away for that all-too-familiar emergency.

Documenting and dealing with your health care (including insurance) becomes a stressful but required chore. It’s not about your health anymore… it’s about the drug war, and addiction, and the DEA, and the AMA, and the ACA, and… more pain.

And next month, you get to do it all over again.

Jaswars

Thank you Mr. Collen for your fiery rebuttal about Ameritox’s term paper which claims they have “concrete evidence” which proves prescription opioids is the new gateway to heroin abuse. Their conclusions are nothing short of one-sided half truths.

This is what their report should have been titled;

“The DEA’s blatant disregard for the proper & ethical treatment of the Chronic Pain Sufferers created a failed health system that is directly responsible for this Alarming Increase in Heroin Use among Chronic Pain Sufferers?

Has the entire pain industry turn a blind eye to these known facts that the DEA completely decimated the ethical treatment, dignity, and respect for chronic pain patients? While I do agree that it is the DEA’s job to arrest, shut-down, and prosecute the illegal activities performed by shady doctors & the pill mills, it is NOT the DEA’s job to turn this industry into a fear induced “Police State” which is exactly what it has become.

The DEA created an atmosphere of fear throughout the entire industry which had affected every single pain patient and provider involved. I believe that is where the paper failed on its merits as well by not including data collection about the DEA’s methods of physician & pharmacy control, patient profiling, plus manufacturing limitations on the drug makers to get these medications to the pharmacy shelves.

This continuous shortage of ‘LIFE GIVING” medications is obvious at every single pharmacy by the gross negligence of the DEA which created an environment which most patients would rather give the DEA the FINGER another valid reason why many chronic pain sufferers may be turning to heroine as a means of relief because of this Apocalyptic Nightmare the pain industry had become.

Simply put, it is just easier to forgo the entire medical field because it is working completely against the legitimate sufferers with nowhere to turn except to hit the dealers up on the streets to purchase their heroine. The DEA’s interference is crystal clear. The Pain Industry had failed its patients because of the DEA. The DEA created an atmosphere so choking as I can tell you firsthand I loathe going to my doctor to pick up my prescription every month, it is a major hassle in every way to get the proper treatment without any harassment, embarrassment, and ridicule by any health care professional.

We are systematically being illegally profiled (Walgreen’s notorious), ridiculed, and literally being swept under the DEA’s mat only to be forgotten.

I can only believe that if this report is saying that 1.3% of the pain patients show heroin in their system and this is from a number as high as 177,000 patients, then I must say, I am amazed at how such a low number is causing any concern at all.
Is it possible to take the people who did these studies and arm them with different questions where they could see some eye-popping numbers, like for instance: “How many of these patients had trouble getting their pain meds in the last 6 months?”, or, ” How many of them have lost their job or their insurance, their families, their houses?” or ” How many have contemplated suicide in the last 6 months?” or “How many were addicts before pain became involved?” or…
the list of better questions, more important and engaging things to study is, as usual, very long, yet for some reason we feel the need to study the mundane, looking for the importance. How about this one, “How many patients don’t trust or believe in studies anymore?” Now substitute the word “studies” for…”Politicians, DEA agents, doctors, science, medicine, the system”…you see what I mean?

moonie

This article is horse pucky! putting it nicely. I’ve had chronic pain for 1/2 my life of 43 years. 2 neck surgeries, brain surgery last year and I am 3 mos post op from emergency open heart surgery. I almost died! I’ve had plenty of opportunities to abuse pain meds but I haven’t. I have NEVER abused them NOR touched heroin or cocaine, etc. It doesn’t interest me! In My Opinion, people who have an addictive personality are going to find something to abuse no matter what! Canned air, paint, food, throwing up, whatever is their addiction of choice. Mine is television. What a hard habit to break for me. I pray doctors and pharmacies and the government either 1. Get some sense about chronic pain and deal with it in the best interest of the patient, after all we are FIRST. 2. Know someone, have chronic pain themselves or are affected by someone who can reach their heart to understand not all of us are drug addicts! I do take low doses of oxycodone and valium, it’s usually enough to get me out of bed and I am able to maintain employment, even though I lost my career I loved of 18 years due to Trigeminal Neuralgia, yeah that hurts. My Dr would not release me back to that stressful job. That’s a whole other issue to deal with.. corporate america.. don’t get me started on that!

Charles Smith

I would love to read this study for myself. Not that it seems to have any scientific merit whatsoever, but so that I might possibly understand where they got some of the numbers that have been quoted in the article above; “66% of heroin users used both heroin and prescription painkillers in the last month. 56% of the positive heroin samples did not contain a prescribed painkiller.” Forgive me if I’m wrong, but unless they are quoting these figures from two different studies, with two different sets of samples, then there is no way that these figures can be correct. 66% tested positive for both heroin and pain medication in the past month. That would leave 34% who did not test positive for pain medication. Or if 56% of the samples did not contain pain medication, then only 44% would have tested positive for both. The only way these figures can be anything but a blatant lie is if they are pulling them from more than one source, which is a whole other form of lying in and of itself; often seen in highly politicized statistics such as this. Or maybe they just went out there, tried their best, and gave us all 122% for this study. Of course now that I’ve read the link to the study, the quote of “56% of the time, in heroin positive samples, the opioid prescribed the patient was NOT detected” makes a bit more sense than the amended version, but it still seems convoluted at best. Still not sure how both figures can co-exist. As to the 1.3%, I have a modest proposal of sorts. I’m sure that if it had been included in this study, then they would have found far more that 1.3% of pain patients had a Pepsi (or some type of soft drink) in the last month. I’m sure the same could be said for the heroin addicts too. So I’m guessing that it would be fair to say that Pepsi is also a gateway drug to heroin. It must be, given that at least 1.3% of pain patient and/or heroin users must have drank a Pepsi in the last month. Because of this I think that we should ban Pepsi or at the very least make sure to reclassify it so that no one under the age of 21 can legally drink Pepsi. We should put that on our national todo-list; unless that is you feel the need to reschedule it. I shudder to think that there may be some misguided soul out there who will not get the sarcasm in that logical fallacy. More to the point my Pepsi proposal (much like this study) is an Appeal to Probability (with conclusions that are statistically improbable based on the findings). 1.3% just isn’t very significant. If this was a life saving medical treatment would you have less faith in the treatment that offered you a 98.7% chance of living than you’d have in the treatment only offered a… Read more »

Johnna Stahl

To Charli:

I think it’s important for chronic pain patients to understand that part of managing the condition is being aware that our pain levels are somewhat based on our own perception of pain. Things like stress and lack of sleep can not only negatively impact the physical aspect of pain, but also alter our perception of pain levels.

It sometimes gives me hope to think that if I can alter my perception, I may be able to reduce my pain — especially when very few other things do.

After 25 years of seeking treatment in the medical industry, I can recall one doctor who offered the only good piece of advice I ever received (paid for) during that time — Distraction.

The ability to distract your mind (and change your perception) from constant pain is not an easy one to develop. I’ve been working on it for many years and can only find distraction for very brief periods of time. It’s a lot of work, but I have found that medical cannabis is a tool that can really help.

It has also helped me to accept that, at this point in time, these brief periods of distraction are the best that I can expect in the way of relief. (I think medical cannabis has helped me with the acceptance part, too.)

Too many pain patients understand the fear of out-of-control pain levels, so high (no pun intended) they can drive you crazy (literally). But the brain is an amazing organ that will surprise you with its strength and plasticity.

After 10 years of a prescription drug regimen, when I ran out of meds, I didn’t think I would be able to handle the pain. But the experience forced me to re-analyze my choices for treatment, and in the end, I made a better and safer choice. I had to move to a different state to access it, but it was definitely worth it.

(And in case you’re interested, here in New Mexico, veterans are very active in the medical cannabis community.)

Charli, I am no one special, and I don’t consider myself a particularly strong person. So I know that if I was able to create and implement my own pain management program — and figure out a way to access what works for me — you can do the same.

Don’t give up, Charli. I have faith in you. 🙂

Charli

As a veteran who was a drug ed spec in the military and who has spend my life studying drugs/addiction/dependence I can say this whole idea that pain killers lead to heroin is BS. Just one more myth brought to us by the DEA. What do most chronic pain patients do when they’re denied their needed pain meds? They kill themselves, they don’t turn to heroin mostly because they are not criminals or addicts. Why not just legalize everything and allow adults to act like adult. Prohibition didn’t work for booze and it isn’t working for drugs. I can remember when pot was a gateway drug. There are no gateway drugs, you might as well say that peanut butter is a gateway drug or TV. Addicts are addicts. You can’t save them until THEY decide they don’t want to use. And because they decide to be addicts law abiding citizens are sentenced to pain because they’re denied correct and rational medical pain treatment.
The VA cut me back on my pain meds several years ago. Until that point I was able to lead a semi normal life, now I’ve lost so much function and am in so much pain that I have no normalcy in my life. I can’t sleep because of the pain, I’m no longer a wife to my husband and I planned my death because I don’t know how much longer I can tolerate my pain which increases daily. But what does it matter, it’s just one more dead veteran.

Donna

The conversation saying opiate medications lead addicts to heroin is BS. Addicts would use heroin anytime if it was easily accessible because I have heard it’s much cheaper than prescription medicine on the street. They aren’t just increasing the use of heroin because opiates are more restricted. Those addicts would use it either way.
I hate this idea that pain medicine is the gateway to heroin.
I thought this website supported pain patients?
The huge amounts of negative media is harming innocent people suffering with pain, so why keep adding more articles online that are causing more suffering and limiting access for those who need pain medication?

Christina

Why don’t they do a study on how patients can’t get there perscriptions. What do they think patients are going to do when they can’t get their meds? Run to the emergency room to be treated like a junkie?
Why don’t they do a study on how pharmacist who have NO education on diease and injuryies. Are denieing legitimate patients access to needy medications. This is the reason for increase in Herion use. Why don’t they look back when herions averages were low before the DEA started their war on patients. Look back to those numbers and when the supplies started getting cut to each state. That is the reason for the rise of Herion use and why. Don’t take no a geniuse to figure it out. Don’t matter anyways the government will always make it look like their in the right and trying to save people from themselves.

Kurt W.G. Matthies

It’s funny how the same data can lead to different conclusions, depending on one’s perspective.

If certain protocols are not followed when doing science, we often find, not scientific truth, but exactly those results our biases are looking to confirm.

Of course, as a chronic pain patient, I see these numbers differently from the study authors.

First, we’ve never before tested at the rate we’re testing today — more testing, more heroin use uncovered. No surprise here.

Pain patients are not looking for heroin highs, for the most part. We know there are plenty of abusers (about 10% according to most studies) who look for both pharmaceuticals and street drugs, “chasing the dragon” of opiate-induced pleasure.

However, if we consider the 90% of chronic pain patients maintained on opioids, they are seeking adequate pain relief.

Because of the pharmacodynamic of opioids in opiate tolerant chronic pain syndromes, and because doses are being limited to the 120mg morphine eq. / day (or less), regardless of efficacy, people are receiving doses that do not cover their pain, and many chronic pain patients perceive they are under medicated.

Look at any pain site where users come with their problems. Many have to do with lack of medication, under medication, no dose changes in years, artificial limits that have nothing to do with medicine and everything to do with a PCP’s comfort zone in prescribing these medications.

Rather than chasing the pleasure dragon, chronic pain patients are chasing that elusive creature called adequate pain relief.

Some, especially the younger patients who are not being treated solely due to their age, are resorting to remedies that are more readily available — street drugs.

If this is in anyway true, the question is, which is worse?

Is it better to deny young chronic painers pharmaceutical grade analgesia, or relegate them to street drugs containing unknown quantities of opiate?

People will self medicate, and no amount of anti-diversion, regulation, testing, controls, or the war on drugs will stop it.

Only adequate, compassionate pain treatment for the millions who are suffering will help to reverse this trend.

Ken

1.3 %. ?? Addicts will be Addicts. Such a small percentage.How can you publish this with such a low percentage and it being an totally unscientific study? Looks like Ameritox is just looking to be published and more business while Chronic Pain Patients suffer. Nothing but Sensationalism.

If those of us who are in chronic debilitating pain would get prescribed the opioids we need to manage the pain then maybe people wouldn’t have to resort to the “least expensive painkiller” out there on the streets! (And BTW: WHO takes 80mg of Oxycodone in a “single dose”? A “single dose” is 5mg, thus the comparison should be $10 for a single dose of heroin and $16 for a single dose of Oxycodone! The price difference then becomes a LOT narrower.) This study is ridiculous! When I WAS prescribed opioid painkillers, I did not abuse them and now that doctors are too afraid to prescribe any, and so I can’t get what I NEED for my MANY chronic pains that ONLY opioids relieve, I have NO desire or inclination to use heroin! I truly would rather be in constant pain than use HEROIN!!! Marijuana used to be considered a “gateway drug” but that’s been getting legalized in many states with more to follow. The Substance Abuse and Mental Health Services Administration need to get their heads out of their “you know whats”. They can’t blame Marijuana anymore so they have now chosen opioids – as a “gateway drug”. They have to keep choosing “something” in order to keep being funded.

Marty

The fact of the matter is that some chronic pain people are being forced to buy heroin because they can’t get the drugs they need to control their pain. Doctor won’t prescribe or they can’t afford them. Living with chronic pain I can only imagine having to make that decision but when you are in constant pain and can’t get pain killers, well………………

On its own merits, this article leaves much to the imagination of the reader.

In conclusions within the report, remarks such as,”Ameritox may not understand the meaning of the words ‘science,’ ‘research report,’ or ‘concrete evidence.’ I could imagine a junior high school student coming up with a similar conclusion based on their graphics but of course he would fail, much like Ameritox has at their attempt at ‘science.’” Collen wrote in an email to National Pain Report.”

This observation, along with the obdervation by Bob Twillman, PhD, Deputy Executive Director of the American Academy of Pain Management, who remarked, “This is challenging (report) to respond to, because it’s a bunch of thrown-together facts without any discussion to hold them together and get them to a meaningful conclusion,” Dr. Twillman also explains,”“I do think that it’s entirely possible that the sharp increase in opioid prescribing after about 1995 has contributed to this problem by exposing more people with a vulnerability to substance abuse/addiction to opioids than were exposed in the past,” Twillman said in an email to National Pain Report.

Which brings us back to the root of the entire problem. The Joint commission and its demanding of the “fifth vital sign is pain” in 1995. If only we could have seen into the future and known what Purdue Pharma was creating was a one-way road to a dead end.

Now, with patients living much longer than previous decades, debilitating diseases, quality of life issues surpassing quantity of life, and no options other than the opioids everyone wants to put at the center of the issue, where do we go from here?

I know, personally, by the time I finished reading this publication, I haf drawn no solid conclusions that prescription pain medication could be called a gateway to heroin.

*** SEPTEMBER IS PAIN AWARENESS MONTH ***
>> SEE WHAT WE ARE DOING FOR PAIN PATIENTS<<
“Opposition to Kentucky HB 1-Reform HB 217 aka "Pill Mill Bill"
https://www.facebook.com/pages/Opposition-to-Kentucky-HB-1-Reform-HB-217-aka-Pill-Mill-Bill/595049517218134

I take Oxecotin and Oxycodene.
They are both good for me.
There is no way will I put a needle in my
arm.

Mark Maginn

Once again, in support of the existing line, opioid medicines are the scourge of western civilization.The question all researchers need to ask themselves, and then, god forbid research, is the following: If you were in chronic, daily, hourly mind-shattering pain, would you even consider giving or selling to someone else the very? If you can answer this question affirmatively, then I, and others like me, would say that (1) you are a liar, or (2) you have never lived with crushing pain.

Again, what is totally missing from this and like studies is patently obvious: while doing an necessary literature search, these people did not gather together a group of chronic pain patients whom they could have turned to in an attempt to understand the ravages of pain. Until an investigator does this, the resulting evidence to me is simply horsesh–!