Most of us have heard that there is an Opioid Epidemic on the rise in the United States. And, as I wrote in a recent newsletter, seniors are very likely candidates for addiction for many reasons. Most of us are used to being able to deny involvement in “unsavory” issues like addiction – which is something that happens to “other families”. But, the Opioid Crisis is leveling the playing field – for better or for worse. For this reason, we are going to need to begin to deal with addiction and recovery issues in our families and our communities.
How did it happen?
As always is the case, there are many so-called causes of the Opioid Epidemic. CNN provides a very interesting timeline with Fast Facts here. If you are willing to invest some time in a very in depth study, I found Sam Quinones’ Dreamland – The True Tale of America’s Opiate Epidemic to be a fascinating read. From my readings, I have gathered that one of the most crucial moments in the history of this crisis occurred on January 10th, 1980 with the publication of a letter titled “Addiction Rare in Patients Treated with Narcotics” that was published in the New England Journal of medicine. This simple 101 word letter (frequently referred to as the Porter and Jick letter, after the authors of the letter, Jane Porter and Dr. Hershel Jick of Boston University), stated that, of their 11,000+ patients treated with narcotics, there were only four cases of addiction This letter provided no further evidence to back up the claim, nor was it a peer reviewed study. Unfortunately, the lack of evidence or study did not prevent large pharmaceutical companies from quoting the Porter and Jick letter as evidence of the safety of their products.
Up until 1980, most doctors had reservations about prescribing narcotics to their patients, but, with the publication of the Porter and Jick letter, pharmaceutical companies began a nationwide PR campaign to convince them otherwise. As word spread about the supposed safety of narcotic pain relief, well-meaning doctors became more and more willing to prescribe narcotics to treat post-surgical pain. Medical Pain Clinics began to spring up across the US in record numbers, providing prescriptions for the narcotic relief of chronic pain as well. Of course, as the incidence of narcotics prescriptions increased, so did the number of patients who developed addictions to these dangerous drugs. As drug companies tried to stem the tide of new addicts, they came up with new formulas and methods of administering narcotics with the intent of making them less habit-forming. But, the proverbial Genie was out of the bottle by that time, and by 2016, statics have found that approximately 11.5 million Americans over the age of 12 have misused prescription pain medications.
It is quite interesting that, as our awareness of the true addictive nature of these medications comes to light, doctors have once again become more hesitant to provide prescriptions for narcotics. Large, government-led “drug busts” and legislation aimed at curbing the availability of narcotics have significantly decreased the incidence of new prescriptions. Which, is a good thing – except for those millions of Americans who have now become addicted to these narcotics through the use of completely legitimate, although misguided, prescriptions. One of the now well-known facts about narcotic dependence is the horrible withdrawal symptoms that accompany the person who is trying to wean him or herself off of the drugs. Once your body is dependent on these drugs – which can occur in a crazy-short amount of time (even less than one month of regular consumption of a narcotic pain reliever can result in addiction!) – “quitting” taking the drug can result in illness involving severe flu-like symptoms, which can last from 3-14 days. Many now-addicts cannot withstand the pain of the withdrawal, and begin to search out other ways of getting renewals on their prescriptions including lying to doctors, switching doctors, and some even stealing medications from those who are legitimately using the drugs. As the US continues to crack down on opioid prescription practices, the incidence of heroin addiction is rising in equal proportion. Heroin is both inexpensive and easy to find on the street. Many who have unwittingly become addicted to prescription narcotics are unaware of the transient nature of the withdrawal symptom and /or are unwilling to ride out the duration, turn to new forms of pure heroin from Mexico. This heroin, unlike the heroin of the early 70’s, is cheap, pure, strong and may now be even simpler to get than a new narcotic prescription. Thus, many who start out with a narcotic addiction as the result of a legitimate post-surgical prescription, move onto heroin after they find they are unable to renew a prescription for a legal narcotic.
As we stated in our recent newsletter, seniors are at increased risk of developing addictions to narcotic pain relief medications because they simply are prescribed more medications than any other age group (seniors make up 30% of the prescription medications, but only make up 12% of the current population). Not only are our seniors at risk in this Opioid Epidemic, they also grew up in an era when having an addiction or mental illness received a great deal of stigma, and where families were often discouraged from talking about such issues. So, while seniors are at specific risk, they are most likely the portion of the population that remains both the least aware of the issues and the least likely to seek help. Which means that we, as adult children, caregivers and support providers must be particularly vigilant and knowledgeable about the widespread effects of the opioid epidemic and the options available to avoid abuse. This article by the Justice Speakers Institute does a wonderful job of presenting the dangers specific to seniors.
For further information on how physical fitness helps to combat pain naturally, thereby avoiding the necessity of prescription pain relief, please see our blog post on natural pain prevention.