A sad intertwining of young and old, in pain and addiction, supply and demand is gripping the citizens of this country as a result of opioids.  Every day - 91 Americans die from prescription opioid overdose.  It is hitting older Americans especially hard. Older Americans are using more narcotic pain pills than ever before and consequently often are becoming addicted.  Twelve million people (1/3 of all Medicare patients) were prescribed opioid pain killers by their physicians in 2015!  The increase in opioid addiction increased 493% between 2001 and 2016!

In 2015, 2.7 million Americans over 50 abused their painkillers (taking them for reasons other than pain or more than prescribed).  Another sad abuse is seniors who sell their pills to dealers for financial reasons.  If an older person is strapped for money for food or power bills, there are ready buyers who will pay $20 a pill and resell them on the street for much more.  This is in addition to the ease with which older patients can get opioids from their doctors.  Even more tragic are the family members and caregivers who steal the drugs to sell.

Physicians who prescribed excessive opioids such as oxycodone, hydrocodone, methadone for patients in extreme pain unknowingly were at the forefront of the problem.  Thinking that long term use was as valuable as short term use, they continued to order refills of the prescriptions.  Sadly, patients found themselves needing and wanting more of the prescribed drug.  A traditional “no questions asked trusting” has gotten in the way of common sense, and serious addiction problems hit patients, their families and physicians head on.  Furthermore, opioid usage is notoriously difficult to treat.  

Within just a few days to a week, one feels the psychological and physical effects of the narcotics.  Choosing to stop taking the opioid often results in side effects and discomfort at first and physical pain follows.  Addicts relapse because withdrawal can bring extreme physical discomfort.  Surprisingly physicians held the belief that seniors would not become addicted through the use of prescriptions drugs.  Latest research suggests that nearly any age is vulnerable.  The CDC (Center for Disease Control) recommends that three days is the maximum these strong pain killers should be taken.  Disregarding this guideline has led to 22,598 deaths in 2015! Judging from the trend, many more per year are dying from this remedy as a result of highly painful injuries, post-surgery, and serious diseases.

Opioids are narcotics that affect mood and behavior; some cause drowsiness and stop the sending of pain signals in the brain.  In addition, they bring on a sense of euphoria and therefore are highly addictive.  For some, this euphoria can lead to heroin, which is two or three times as powerful as morphine.  If prescription drugs become more difficult to get or the tolerance builds up, folks seek more potent drugs to feed their addiction.

Important steps are being taken to combat this crisis.  One step is for us all to realize what is going on and be alert to our own medical journey.  If we are being prescribed an opioid, we can ask what the alternatives are.  If we must take a heavy narcotic, we can use as little as possible for our comfort and well-being and request a plan for when we will be off this drug and onto something less addictive.  

Valuable alternatives to addictive opioids are being used in a number of health care facilities such as St. Joseph’s Healthcare in Paterson, New Jersey.  Dr. Alexis LaPietra, Medical Director of Pain Management, and her staff make extensive use of non-opioid medications, trigger point injections, nitrous oxide and ultrasound-guided nerve blocks.  All of the above pinpoint the nerve that transmits the pain and precisely blocks that nerve.  Prevention of addiction beats the heck out of cure, BUT if one needs treatment for the addiction, many policies will cover the treatment.

Prescription drug addiction is a serious challenge for Montana.  Between 2012 and 2015 one hundred eighty-one Montanans died of prescription opioids.  Educating the public on the dangers is a major part of the battle.  Every Montanan’s job is to be vigilant and alert to our own healthcare as well as the care of our friends and families and get help before it is too late.

Notes:  AARP Bulletin, June, 2017; Public Broadcasting System, News Hour, July 3, 2017; Sibert, M. (2017), Reporter for the University of Montana Community News Service and Montana Newspapers Association on KRTV, July 12.