The 60 Minutes story on the explosion in the use of heroin in Ohio underscored one problem: heroin use is on the increase. And the segment pointed out that the use of opioid pain medication is fueling it.
The story didn’t address the issue that many pain advocates are trying to raise - that addiction and opioid use are not connected that directly.
A former president of the American Academy of Pain Management called the 60 Minutes conclusions “a reductionist view.”
“It is more complicated than just to think of it as a supply issue, said Dr. Lynn Webster, who is author of an outstanding book on chronic pain called “The Painful Truth”. “Politicians and regulators want to vilify something that they can easily do something about but the solutions are not so simple. And those solutions aren’t sexy.”
Dr. Webster thinks all of the emphasis on the consumer is misplaced.
“Payers and government themselves are major contributors to the problem. Let’s have an honest, transparent discussion or we will just continue to lose lives.”
For rehabilitation expert and pain patient advocate Terri Lewis PhD, the problem is overprescribing, but not of opioids. She said that the overprescribing of opioids peaked over ten years ago and that opioids are not in the top ten of drug classes that are being overprescribed.
“Deaths associated with poly-pharmacy (5 or more prescriptions in the last 30 days) are greater than deaths due to opioids,” she said. “My fear is that with the reduction of opioid prescribing in this climate of hysteria, we are seeing an increase in prescribing drugs in the classes associated with overprescribing and drug related deaths. Many of these will be people with chronic pain.”
“This hysteria is supported by people whose industries will benefit from manufacturing a climate of fear and who will prey on the most vulnerable,” she added.” Physicians get paid for the prescriptions they write as a consequence of the visits that are billed. We never measure whether the pills have any impact for the consumer.”
If you watched the 60 Minutes last night, most of the stories about heroin abuse and overdose deaths involved young people. And she doesn’t think this is a problem cause by opioid prescriptions but by something much larger, a sense of belonging.
“As for kids playing with drugs, that is a social and cultural problem unrelated to persons with chronic pain,” Dr. Lewis said. “Kids who play with drugs do it for social connectedness - this is the loneliest generation of young people ever with too much money, time, no social attachments, no jobs…instant gratification.”
Readers of the National Pain Report have also begun to weigh in. For many, the 60 Minutes story emphasizing addiction and the role opioids play in it missed the point.
A reader identified as Martha wrote:
“Adding up stories like the one on 60 Minutes that have been broadcast in the past few years and I’m trying to remember similar stories regarding chronic pain patients not receiving adequate pain management that were broadcast on network news shows. It seems that (coverage of) the addicts far, far outweigh those not receiving adequate pain management. Which explains a lot.”
We’ll be following up with additional commentary. Leave your opinion about the 60 Minutes story.
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@tal7291 (Terri Lewis PhD)