America has a major problem on its hands which many are unaware of. The problem directly effects tens of millions of people, as well as their families and friends. American citizens are being brutally tortured by their own government. These people typically cannot protest or stand up for themselves. They are essentially prisoners who don't face bars... they are imprisoned within their own bodies. The issue is chronic pain. Over 100,000,000 Americans suffer from it, and very few recieve adequate care for it.
Chronic pain is pain which lasts on a long-term basis. Many define the difference between acute and chronic pain as a span of over 30 days. But chronic pain is generally thought of as much longer term or even life-long pain. This is precisely what millions face. Chronic pain can range from being moderate, with little impact on quality of life, to severe and debhilitating, all but destroying one's life. There are many ways to treat chronic pain, some better than others. Over-the-counter pain remedies are helpful for some patients, and some find relief from physical therapy, stretching, chiropractic care, alternative medicine, etc. But for all too many pain sufferers, the pain is so severe and devastating that only narcotic/opioid medications can combat the pain and improve quality of life.
Throughout human history, opium and its derivatives have been used to treat pain. Sometimes too liberally, and sometimes far too conservatively. Opioids are highly effective pain relievers, and are considered a marvel of medical science. An opiate, like morphine, is powerful enough to bring relief and peace to one suffering the most severe pain -- even a soldier who's limb was blown or chopped off or a victim of a horrible car accident. In smaller, more controlled doses, these drugs can relieve moderate and severe severe aches and pain that stems from a myriad of causes. Opioids can relieve a migraine, tooth ache, broken bones, cancer pain, back and neck aches, sciatic pain and much more. Opioids work by binding to receptors in the brain and blocking pain signals. However, this has some side effects. Opioids can cause nausea, constipation, drowsiness, diziness, loss of appetite and loss of interest in sex. But one side effect has brought more attention to the drug than any other: euphoria. A large dose of opioids can put its user into a "blissful state" -- the user may feel sleepy/dreamy, extremely joyful, apathetic towards worries/troubles, etc. Some opioids greatly exaggerate this side-effect (e.g., heroin), while others cause very little of it (e.g., codeine).
Unsurprisingly, this quality has led to the abuse of opioids by those seeking a "high". For recreational users, opioids can be a fun way to spend a weekend, while for opioid addicts the drug can be a way of life and "escape" from his/her troubles and problems. With long-term use, opioids cause physical dependency. The body begins to depend on the drug to relieve pain, and the body does not produce enough natural endorphins to fight pain and discomfort. This is not a problem as long as the drug is taken, but when the drug is abruptly cut off the user will go into withdrawal. Opioid withdrawal can be mild for "light" users, or severe for high-dosage, long-term patients or "heavy" drug addicts. Withdrawal symptoms are similar to a bad case of flu. Among the symptoms of these withdrawals are nausea, increased pain/aches, "cold sweats", runny nose, watery eyes, a "crawling" sensation, restlessness, insomnia, etc. It is extremely uncomfortable but is rarely dangerous or life-threatening. Opioids can be quit, at any time, by a gradual tapering off of dosage, the use of certain treatments/drugs or even the "cold turkey" approach (though it is often unsuccessful for addicts and highly stressful or even downright torturous for patients).
It should be noted that there is a difference between physical dependency and drug addiction. The World Health Organization defines addiction as: continued, habitual use (for non-medical purposes) despite harm. Physical dependency is simply when the body needs a drug so as not to experience withdrawal and discomfort. Almost all drug addicts are physically dependent, but physical dependence is not addiction. For opioids, physical dependence is completely normal for long-term therapy, such that a cancer patient might recieve. Contrary to popular belief, the risk of addiction to opioids is very low within a medical context when the drugs are used properly under a physicians care. The risk is high, however, when large amounts of the drug are used for a "high" on a habitual basis. Even many recreational users avoid addiction by moderation. The risk of overdose is also extremely low for legitimate patients. It takes large doses of opioids, beyond the user's tolerance, to kill. However, the risk can be high for addicts who inject opioids into their blood stream in high doses -- where the line between a "good high" and overdose can be very thin. The majority of opioid-related deaths actually involve a bad combination of opioids and other drugs (especially alcohol, sedatives and benzos) and are not the result of lethal levels of opioids alone. In cases where a true overdose occurs, it is usually the result of intravaneous (IV) injection of the drug -- usually the street form of heroin which is of an unknown potency... the ignorant user unintentionally injects more heroin than they realized or intended.
Tolerance is another important aspect of opioid use. When using opioids for a long period of time, a person becomes tolerant to the effects of the drug -- meaning it takes a bigger dose to produce the desirable effect. This can result in a patient needing stronger medicine or higher doses, or an addict consuming bigger and bigger doses to "get high". However, tolerance does not increase indefinitely. At some point, each user of opioids will reach a "plateau" where consuming more of the drug is not necessary or tolerance grows very, very slowly. This level varies from individual to individual. Some individuals require doses which may seem extreme to another person, while some may attain the desired effect from a weaker opioid in much smaller doses. Typically, patients find a reasonable dosage which works well for them and stick to it -- the drug provides adequate pain relief and consuming more would just make them too drowsy for daily life. Addicts also can find equilibrium, but since their objective is to attain a "high", they may push the limits to increase the effect. The important thing to take away from this is that tolerance doens't go on forever and ever, but is an important consideration when dealing with opioids.
Opioids are generally very safe, extremely effective and relatively inexpensive for pain patients. The risk of addiction for medical usage is quite low, and tolerance reaches a "plateau" at some point. Opioids can be used to combat pain which, left untreated, destroys the lives of millions of otherwise ordinary people. The side effects are generally rather mild at proper doses. Opioids can be much safer than many non-narcotic drugs commonly prescribed or bought over-the-counter. NSAIDS, for instance, often cause internal/GI bleeding, coma and death. The main ingredient in Tylenol, acetominophen, can cause liver and kidney damage that results in death. Many other drugs for conditions like depression, ADD/ADHD, anxiety, etc can also be far more dangerous than opioids, though they are prescribed like candy.
However, opioids are extremely under-prescribed in America and much of the western world, and pain is seriously and severely under-treated. Millions in America alone are denied access to these medications and left to suffer needlessly. For some, this becomes too much to take and they commit suicide to escape the pain forever. Others turn to the black market, paying absurd prices, and fall victim to violence and abuse on the streets. These people are not drug addicts looking for a "high". They are unfortunate human beings suffering from devastating pain, and they deserve to be treated like human beings. Many are also surprised by the racial disparity in pain management. Studies have concluded that black patients, for instance, are far less likely to recieve adequate treatment for pain or a prescription for opioids as whites or Asians. As we speak, real people are suffering all over the US and the world from severe pain. Some have lost their doctors to the "War on Drugs" and have nowhere to turn. Some of them will writhe in the agony of their pain and needless withdrawal. Some will turn to the streets to survive. Others, with more extreme pain, will take their own lives. And the question is WHY? Why are we doing this to people when the drug needed to relieve their misery is sitting on the shelf in a pharmacy. Not even a pocket full of money and premium health insurance can rescue them from the suffering, since obtaining a simple prescription can be all but impossible. The reason is public and government hysteria over drugs.
Sensational "journalism", government propaganda and myths have taken the US and the west by storm -- demonizing opioids that millions need. Governments began "cracking down" on what they deemed a problem and wildly exaggerated. Thousands of doctors have been forced or scared out of business by the DEA. Many have been arrested for simply treating their patients properly. The few cases where doctors were actually breaking the law and diverting drugs to the street intentionally recieve major attention from the press and are hyped up to epic proportions; only making the problem for too many Americans much worse. Medical students are being advised to completely avoid the practice of pain management. Doctors are being advised to NEVER prescribe opioids for any reason. The DEA uses threats and so-called "inquiries" to frighten doctors who prescribe pain medication. Most doctors tell their patients "I'm afraid to treat you because of the DEA and FDA". They have also placed arbitrary "quotas" on the amount of prescriptions pharmacies can fill, how much medication can be prescribed to a patient and/or how many patients a pain specialist may see. The results have been devastating...
There is now a major shortage of doctors who treat pain. Desperate patients find the few remaining doctors and flood into their doors. The DEA then deems it "suspicious" that these doctors write a lot of pain medication, and falsely label them "pill mills" for legitimately treating patients. Sometimes even patients get arrested for merely going to a "suspicious" doctor. This problem will only become worse as fewer and fewer medical students go into the field of pain management. Regulations on the remaining doctors have become more strict and assenine. Patients are now required to visit the doctor every 30 days, despite the fact that their pain is unchanging or life-long, and submit to a drug screening they must pay for. Many clinics have gone "cash only" as a result, and the cost can range between $300-$800 per visit. This expense can be financially devastating for many patients.
Furthermore, this has caused a supply/demand crisis for the drugs themselves. It has caused the street value of prescription opioids to skyrocket. A single 30mg oxycodone tablet, which costs as little as $0.70 from a pharmacy, sells for $30 on the street. Yes, $30 for a single pill... An 80mg tablet of the time-realeased drug Oxycontin (the brand-name of a time-release formulation containing oxycodone) can sell on the streets for up to $100. With the high, unsatisfied demand of legitimate patients turning to the streets (and actual drug addicts), and the huge street prices, it's not surprising at all that we now have a major problem on the streets. This has given rise to the practice of "doctor shopping" and "doctor hopping", where drug dealers visit multiple doctors to obtain multiple prescriptions -- the cost of travelling state to state and spending so much time on it becomes worth it for untold thousands of dollars in black market profits. Some legitimate patients have to sell some of their prescriptions to pay the extreme costs this problem has resulted in. With the huge profit potential on the street, violence will undoubtedly follow. A general rule of thumb is that where there is a highly profitable black market, regardless of the commodity, violence will result. Yet we continue the same failed government policy, and refuse to acknowledge reality. This problem has even started the phenomena of armed pharmacy robbery. Why rob a gas station when you can rob a pharmacy for thousands of pills worth $30 a piece? Even "big pharma" has felt the effects, as many of their shipments are stolen and trucks are hijacked.
Something must be done. This is one of America's biggest medical crises that is sadly unnoticed. Some commonsense must be restored in America, and our hysterical attitudes must be brought under control. I, for one, am personally a victim of this hytserical nonsense. As I'm writing this, a friend of mine, also a victim, is lying at home in bed, who just had her foot amputated, with no pain medication. The doctors simply would not give it to her. She's sick and miserable, and hurting worse than I can even imagine, and all I can do is pray for her and cry.
I hope that all of us can heighten our awareness of this issue and work towards spreading awareness and resolving the problem despite our political differences. Thank you for your time...
Regards,