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A Doctor Speaks Out On The Perils of Pain Meds

(Stephen G. Gelfand, MD, FACP, FACR) - More than 10 years ago, I wrote a commentary in The Rheumatologist, called “Perils of Pain Meds,” about the over-prescribing of opioid analgesics for common causes of chronic noncancer pain, which was a major contributor to the opioid epidemic.

Since that time, although there has been a greater than 20% decrease in opioid prescribing, the opioid-related death rate, per data from the Centers for Disease Control & Prevention (CDC), has significantly increased, driven by people with the potentially fatal disease of opioid addiction, many of whom turned to illicit heroin, often laced with deadly fentanyl or its analogs.

This has occurred, in large part, when patients with chronic pain turn to these much cheaper, but deadly, opioids obtained from the streets when they are no longer able to obtain prescription opioids, which initiate opioid addiction in four out of five people addicted to heroin. Additional recent statistics are sobering. In 2016, opioid-related deaths continued to rise, with more than 42,000 deaths in total—more than 17,000 due to prescription opioids, more than 15,000 due to heroin, and more than 19,000 due to synthetic opioids (mainly fentanyl and its analogs). Every day in 2016, 116 people died due to opioids. The economic costs nationally were estimated at a staggering $504 billion.