Painkiller Use Surpasses Tobacco Use.

Last month we wrote about Tennessee’s dubious distinction in 2015 of being second in the country only to Alabama in the number of opiate prescriptions written – 1.6 prescriptions for every man, woman, and child in Tennessee.  And that for the first time the fatalities caused by drugged drivers surpassed the fatalities caused by drivers under the influence of alcohol.

Another statistic caught our eye this week.  NHTSA published a study that found that 38% of U.S. adults used prescription painkillers, compared with 31% who used tobacco.  The statistic does not show declining tobacco use, but demonstrates the increasing use of prescription opiates.

Here are our thoughts on what’s behind the opiate epidemic.  We are sure that many of our readers remember the “Just Say No to Drugs” campaign spearheaded by Nancy Reagan in the 1980s.  What we’ve always thought was unspoken but clearly understood was a second phrase “Just say no to drugs… Unless given to you by a person in a white coat.”  Drugs that are prescribed by doctors do not have the same connotations that street drugs do; if a doctor prescribes them, they must be ok.  Marijuana = street drug = bad; Oxycodone = prescription drug = ok.

The fact that doctors can write prescriptions for opiates that generate billions of dollars in profits for pharmaceutical companies is a major reason why we have the opiate problem today.  Pharmaceutical companies are not so willing to give up their earnings – after all, they have a responsibility to their shareholders to make money!  It’s jarring to read an article in the Wall Street Journal about efforts to hold down the cost of drugs that contributes to rising health care costs, then to read another article in the same issue about a pharmaceutical company alerting their shareholders that they may have difficulty sustaining the annual price increases for their drugs, and that may impact their ability to continue to increase their profitability.

We’ve always thought that one reason doctors prescribe so many painkillers is a well-intentioned effort to satisfy their patients.  If a patient leaves their doctor appointment empty handed – without a prescription – they are likely to feel that they did not get their money’s worth out of the doctor visit.  That pressure to satisfy patients’ expectations, and what we see as a medical culture that is shared by doctors and patients in which prescription drugs are the answer to what ails us, is another major reason for the enormous amount of opiates being prescribed in the U.S. today.

So what’s the answer to the opiate epidemic?  Given that we believe the problem is deeply rooted in our medical culture of drugs as the answer to what ails us, and our country’s for-profit, capitalistic health care delivery model, we can only believe that most immediate solutions will only scratch the surface of the problem.  But perhaps pushing for small changes, such as emphasizing alternative pain relief methods such as acupuncture, etc., is how we start to make changes to our medical culture.