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We’ve been sold down the river by Big Pharma

Tuesday, Mar 6, 2018

* AP

A yearlong study offers rigorous new evidence against using prescription opioids for chronic pain.

In patients with stubborn back aches or hip or knee arthritis, opioids worked no better than over-the-counter drugs or other nonopioids at reducing problems with walking or sleeping. And they provided slightly less pain relief,

Opioids tested included generic Vicodin, oxycodone or fentanyl patches although few patients needed the most potent opioids. Nonopioids included generic Tylenol, ibuprofen and prescription pills for nerve or muscle pain. The study randomly assigned patients to take opioids or other painkillers. That’s the gold standard design for research.

If they don’t work better than less risky drugs, there’s no reason to use opioids given “their really nasty side effects — death and addiction,” said lead author Dr. Erin Krebs, a physician and researcher with the Minneapolis Veterans Affairs Health Care System. […]

About 42,000 drug overdose deaths in the U.S. in 2016 involved opioids, including prescription painkillers, heroin and fentanyl. Many people get hooked while taking opioids prescribed for injuries or other short-term pain and move on to cheaper, more accessible illicit drugs like heroin.

Krebs said the strongest evidence from other studies shows that physical therapy, exercise or rehabilitation therapy works best for chronic pain. And she said noted that there are a variety of nonopioid drugs to try if one type doesn’t work.

The study is here.

- Posted by Rich Miller        

  1. - Keepin' Track - Tuesday, Mar 6, 18 @ 11:46 am:

    When somebody needs a powerful pain killer, then yes…it’s good to have these options available. That should be up to the doctor and the patient, and probably not the “physicians” in the legislature. On the other hand, what’s up with my kid getting 20 Vicodin pills for a single tooth extraction?

  2. - Moe Berg - Tuesday, Mar 6, 18 @ 11:50 am:

    Thanks for posting. Evidence-based approaches to health care treatment and policy are essential; research like this can save lives and money, besides preventing untold misery.

  3. - Tequila Mockingbird - Tuesday, Mar 6, 18 @ 11:53 am:

    Opioid narcotics are effective for acute nerve pain. When the pendulum swings far enough they won’t even be available for that. They have been overused over prescribed for years. It’s good that finally they get around to the studies.
    The number of overdose deaths outnumber gun deaths by a huge margin.

  4. - VanillaMan - Tuesday, Mar 6, 18 @ 11:54 am:

    Opiods turn me from Dr. Jeckyl to Mr. Hyde. They’re terrible medicine.

  5. - Annonin' - Tuesday, Mar 6, 18 @ 11:54 am:

    Just Big Pharma? How about guys like GovJunk who front for them when folks are trying to get medical marijuana approved for chronic pain?

  6. - FormerParatrooper - Tuesday, Mar 6, 18 @ 12:00 pm:

    After I broke both my wrists and had surgery I was prescribed Vicodin and while it helped I understand how people get addicted to these meds.

  7. - wordslinger - Tuesday, Mar 6, 18 @ 12:06 pm:

    The quadrupling of opioid scripts was never about medicine, but about creating a market for new products.

    It’s akin to the introduction of crack in the 1990s, but just so cultured and respectable. Some of the “best people” were involved.

    Both the WSJ and NYT over the years have done brilliant journalism on how this all came about: the swag to doctors to write the scripts; the revolving-door corruption of regulators/lobbyists; and the legal bribery in the form of campaign contributions for lawmakers to look the other way.

    They should all be in the dock with El Chapo, the way they purposely hooked so many people on legal heroin. Because that’s what it was, nice and respectable heroin.

  8. - PJ - Tuesday, Mar 6, 18 @ 12:07 pm:

    A nice addition to this post would be the news from last month that the Rauner administration is appealing the court decision that required they add intractable pain to the list of qualifying medical marijuana conditions.

    Wouldn’t it be nice if people had access to medication that actually made them feel better and that they didn’t OD and die on?

  9. - Anonymous - Tuesday, Mar 6, 18 @ 12:14 pm:

    I had major back surgery and they helped a lot

    I got off of them as my back got better but it took about a year

    I took less and less until I did not need them anymore. I was back to work within two months of the surgery and by then was only on one at the most every few days. I used a cane for 14 months while in physical therapy

    To sum things up, they helped me

    Of course, I have never had an addictive personality except for smoking. I quit thousands make that millions of times before I was able to quit for good eight years ago but i know that one can get me right back in the habit so I stay away

  10. - Anonymous - Tuesday, Mar 6, 18 @ 12:17 pm:

    Found tylenol worked only slightly less better than
    oxycodone but the advantage of only tylenol is that I had a less “drunk” and out of control mental feeling.

  11. - 44th - Tuesday, Mar 6, 18 @ 12:22 pm:

    I took Demerol after my surgery 12 yeas ago, I stopped it fast as in a very short time I got a “taste” for it. 12 years later I still remember how good it felt.

  12. - Dome Gnome - Tuesday, Mar 6, 18 @ 12:24 pm:

    I wish they would give serious consideration to studying CBD oil.

  13. - Soccermom - Tuesday, Mar 6, 18 @ 12:27 pm:

    I was a health reporter when these new drugs came out. I remember digging into the studies and interviewing highly regarded doctors about this new, SAFE approach to treating pain. I talked with people who had been crippled by chronic pain, and who credited this new class of drugs with giving them their lives back — without fear of addiction. Now I feel like a chump - and worse, I wonder how many people who read my articles thought they were taking a safe drug, and then wound up addicted.

  14. - Anon221 - Tuesday, Mar 6, 18 @ 12:31 pm:

    Keepin’ Track- ” On the other hand, what’s up with my kid getting 20 Vicodin pills for a single tooth extraction?”

    Been there and questioned that, too. There are physicians and dentists who are now changing their prescription “habits”. It’s time to question ’scripts and not settle for the lame response of , “Well, you might need them”.


    “Among prescribers of opioids for adolescents, dentists are proportionately the most prevalent prescribers (Fig 1).6 This is consistent with the Department of Health’s assessment of acute opioid prescriptions in youth using the Prescription
    Monitoring Program data between July and December
    2015.7 Dentists write approximately 31% of opioid
    prescriptions for patients between 10 to 19 years.8 An estimated 56 million tablets of 5 mg hydrocodone are prescribed after third molar extractions each year in the United States.8 High schoolers who receive an opioid prescription are 33% more likely than those who do not receive a prescription to misuse opioids between the ages of
    18 and 23 years.9 Data shows an upsurge in heroin‐related deaths among 18 to 25 year olds. 1,2 Therefore, dental providers could play a critical role in minimizing opioid exposure for vulnerable young people by reducing the number of opioid tablets prescribed for common procedures
    such as extractions.”

  15. - Belle - Tuesday, Mar 6, 18 @ 12:36 pm:

    Dome Gnome—because CBD oil is a natural product, Rx Drug cos cannot patent and make a zillion $ so they don’t care about it. At one point, about 10 yrs ago, a bunch of the drug companies set up offices in Beijing to try and figure out how to patent Chinese herbs. That didn’t work out.
    Since they need money to run the studies, herbs, CBD oil and med marijuana don’t get many studies dedicated to their efficacy.

  16. - Anonymous - Tuesday, Mar 6, 18 @ 12:38 pm:

    NSAIDs like ibuprofen or acetaminophen work without the addiction of opiates but can also be abused on dosage, leading to serious damage to the liver or in some cases, erosion of the esophagus requiring surgery. They’re recently also been linked in some studies with male impotence. So cannabinoids might look better long-term.

  17. - Arthur Andersen - Tuesday, Mar 6, 18 @ 12:50 pm:

    word is spot on here, as usual. Bruce Ruston has an excellent piece in this week’s Illinois Times about a fine, upstanding Springfield family business that distributed tons (literally) of Oxys, including about 4 million to a pharmacy in Nowhere, W.Va pop. 2100 before getting religion and ratting out to the DEA, who did a lousy job of oversight (Thanks, Obama) of this industry.

    Regular readers here know AA has suffered from bad migraine headaches for years. Opioid pain pills were part and parcel of treatment for a long time, until my headaches were eradicated by, of all things, Botox. Don’t miss the dope, and I don’t have a wrinkle in my forehead.

  18. - Techie - Tuesday, Mar 6, 18 @ 1:03 pm:

    As someone here mentioned, CBD is a naturally occurring chemical in cannabis and hemp both. It is effective in treating chronic pain, as people like former professional pitcher, David Wells, will attest to:

    Unlike THC, CBD is not psychoactive and will not make you feel high. It has few, if any, negative side-effects. CBD extracted from cannabis is only legal in states which have legalized it. However, CBD extracted from hemp is legal in all US states.

    Once the medical community is released from the grip of big pharma, perhaps they will make it clearer that there are safe, effective, natural remedies to pain which don’t require dangerous pharmaceuticals.

  19. - Amalia - Tuesday, Mar 6, 18 @ 1:13 pm:

    oh for the use of Med Mar! Vicodin and me do not mix, but for my husband’s dental nightmares, super necessary. Oxy is very, very interesting, and deceptive because it feels like nothing but you are blissed out. lots of substances can be addictive, including foods. Body chemistry plays a role.

  20. - Steve Rogers - Tuesday, Mar 6, 18 @ 1:16 pm:

    I wish the medical community would look at alternatives to prescribing drugs. It seems when someone goes in because their arm hurts, for example, the first response is to prescribe drugs. Maybe a better idea would be treat the problem rather than the symptoms. Maybe it’s a pinched nerve, maybe it’s something a physical therapist or chiropractor can resolve, maybe massages can take care of it. I’m not anti-drug; it just seems the easy solution is to take a few pills and be done with it. However, the best solution isn’t always the easiest.

  21. - Soccermom - Tuesday, Mar 6, 18 @ 1:20 pm:

    Of course the pharma companies can make money on cannabis-based products. (As you may have noticed, the tobacco companies make money on a natural product.) They just make more on opioid sales. (Also the federal government makes it very difficult to conduct research on cannabis or its compounds.)

  22. - Anon221 - Tuesday, Mar 6, 18 @ 1:29 pm:

    Just posted on NPR- Jump In Overdoses Shows Opioid Epidemic Has Worsened

  23. - SOIL M - Tuesday, Mar 6, 18 @ 1:37 pm:

    Carlisle County, KY has just announced a new Hemp processing plant set to open. That along with the hemp being grown in KY has opened up options for farmers and jobs in West Ky that, once again, would have been nice on this side of the river.

  24. - Union thug - Tuesday, Mar 6, 18 @ 1:48 pm:

    I been saying for a Long time. They don’t kill the pain. They make you not care about it.

  25. - cdog - Tuesday, Mar 6, 18 @ 1:49 pm:

    Big Pharma? Sounds rather conspiratorial. /s

    It’s hard to imagine that an unbridled profit motive could induce a group of people to make decisions that harm another group of people. /more snark

    Of course, when a different group of people begin falsifying the narrative of the people controlling the narrative, things get a little crazy.

    Not quite checkmate for BigPharma, but a good move by Emanuel.

  26. - LoisLearned2much - Tuesday, Mar 6, 18 @ 1:56 pm:

    Excellent story and info. I suffer from chronic pain and exercise is the best treatment for it, but it is work. Most Americans want a quick and easy fix, so turn to swallowing pills first.

  27. - HangingOn - Tuesday, Mar 6, 18 @ 2:09 pm:

    After knee surgery when I was 19 I was given Vicodin. Only time I ended up taking it was when I was going to sleep. Because when I took it I had no choice, I was going to sleep. Otherwise I took Naproxen when I needed to function. It just didn’t work at night because if I moved my knee in my sleep I was gonna wake up. Now, child birth and my kidney stones were the other times only the heavy stuff was going to help. Can’t pop a Tylenol for those. And even with the stones my doctor gave me a very limited supply of the painkiller so I wouldn’t be on them too long. Too many doctors I think just write a script and don’t think about it.

  28. - Al - Tuesday, Mar 6, 18 @ 2:28 pm:

    Somehow this must be the fault of those who are interfering with the perfect magic hand of the free market. Snark fake Ann rand.

  29. - RetiredStateEmployee - Tuesday, Mar 6, 18 @ 3:50 pm:

    Seems like we have conflicting information. As an aside, I know that nerve pain such as trigeminal neuralgia does not respond to typical pain relief medication. Now people who can benefit from these drugs will be forced to suffer unnecessarily due to the difficulty in obtaining them.

  30. - anon2 - Tuesday, Mar 6, 18 @ 5:23 pm:

    === The quadrupling of opioid scripts was never about medicine, but about creating a market for new products.===

    Another example of what happens when government regulation is lacking, an why adequate government regulation is indispensable to protect the public interest. What are those dentists thinking by prescribing so many opiods to teenagers???

  31. - DuPage - Tuesday, Mar 6, 18 @ 5:34 pm:

    I read a lot of these overdoses occur because when they can no longer get their pain pills at the pharmacy, they turn to other sources. They end up with counterfeit pills that have fentanyl mixed in without knowing it. That’s what happened to “Prince”. He took what he thought was his normal pain pill, but it was actually many, many times stronger.

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