by Karen Telleen-Lawton, Noozhawk Columnist (read the original in Noozhawk by clicking here)
Opioids weren’t always reviled. The powerful class of painkillers was first discovered in 1804, when German pharmacist Friedrich Serturner’s painstaking research isolated morphine as a sleep-inducing molecule found in tarry poppy seed juice. His discovery created an amazing new pharmacological tool in pain management.
Opioids make recovery bearable for surgery patients and normal life possible for the estimated 20 percent-30percent of Americans who suffer chronic pain.
Opioids are “the cardinal feature of a diverse spectrum of diseases, including arthritis, migraine, cancer, metabolic disorders, and neuropathies,” according to the National Institutes of Health (NIH). They include legal medications such as oxycodone, fentanyl, codeine and morphine.
The dark side of opioids is their side effects, over-prescription, and black-market versions, including heroin.
Dr. Anna Lembke, medical director of Stanford Hospital’s Addiction Medicine Department, calls it one of the worst drug epidemics in U.S. history. She urges attention to the role of Big Pharma, the medicalization of poverty, and the neuroscience of addiction.
The NIH calls out the side effects of opioids in arcane medical language. There is opioids’ analgesic tolerance (diminished pain-relieving effects), hyperalgesia (increased pain sensitivity), and drug dependence.
Basically, you need more and more to provide the same effect against pain, but escalating the dosage puts patients at risk for dependence and other medical issues.
Paradoxically, many patients also develop an increased pain sensitivity using opioids, causing an excruciating cycle of pain. The Center for Disease Control and Prevention (CDC) statistics show the devastating result: 2.1 million Americans suffer from opioid substance use disorder; 44 death per day attributed to opioid overdose.
Drug overdoses are now the leading cause of death for Americans under age 50, with two-thirds of those caused by opioids, according to the CDC.
The follow-on to drug addiction in the young population is drug-addicted newborns. Sara Murray, a West Virginia nurse who founded a facility for drug-addicted babies and mothers, says, “We have generational addiction … It was their mother’s normal. It was their grandmothers’ normal. And now, it’s their normal.”
Families who believe they have dodged this particular societal bullet are mistaken. Evidence has emerged from sources as diverse as the Federal Reserve and the CDC.
The Feds report that opioid addiction, “may be shrinking the number of job applicants” by keeping otherwise able-bodied people out of the workforce.
The CDC estimates opioid abuse costs the U.S. about $78 billion a year in medical expenses, lost productivity, and prison costs. Employers report significant problems finding applicants who don’t fail drug tests.
Santa Barbarans are not immune to opioid’s siren call. County Public Health reports a higher rate of non-fatal emergency visits for opioid overdoses than the state-wide average. Half of 2018’s 69 drug fatalities were opioid-related, though fentanyl’s percentage is increasing.
The core of any solution will need to recognize that, until there are better ways to deal with physical pain, opioids will keep their place in the medicine cabinet.
The NIH recognizes chronic pain as a major disability and among the most common chronic illness afflicting individuals younger than 60. Potential solutions also have to account for the breadth of reasons people come to this powerful drug class.
One imperative in reaching a solution is public discourse. The National Issues Forums Institute (NIFI) has taken on this topic with the Kettering Foundation. Their issue advisory is designed for use as a guide by civic and educational organizations interested in addressing public issues.
Westmont College will be sponsoring a National Issues Forum tackling opioids, 7-9 p.m. Thursday, Oct. 24, at First Presbyterian Church of Santa Barbara. The form will address the question: What should we do about the opioid epidemic?
Come add your personal or policy perspective. We need to shed light on this painful topic.
Karen Telleen-Lawton, Noozhawk Columnist
Karen Telleen-Lawton is an eco-writer, sharing information and insights about economics and ecology, finances and the environment. Having recently retired from financial planning and advising, she spends more time exploring the outdoors — and reading and writing about it. The opinions expressed are her own.