History, Mistakes and Misconceptions About Opiate Prescribing and Addiction Risks

Opium Epidemic thier Header

There is an amazingly thorough article on Opiates by DrugRehab.com called

Pain is a very real problem, and seems to be widespread and chronic for many. A balance between pain relief and preventing other issues (addiction being a presient one), is very difficult and cause for much debate over centuries.

We may think that opiate addiction is “new,” but it has been endemic in other ages, even if it was used in different forms. Addiction problems were tragic and  widespread after the Civil War (1865) and in the early 1900’s, causing the pendulum to swing far into the “avoid at all costs” zone instead of finding the balance, safest protocols, and the ideal client.

I’m going to post of few quotes and insights I learned from this article, then just let you go there to learn more yourselves!

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“Opium made its way to the United States around the time of the Revolutionary War, but its use was uncommon until morphine was synthesized from the plant in the early 1800s. During the Civil War, it was commonly used to treat soldiers. At that time, an estimated 400,000 soldiers treated for pain with morphine became addicted to opioids….
“At one time in the 1800s, people could get opioids fairly freely,” Meldrum said. “They were available over the counter. They were available in the mail.”

A Heroin Bottle from the 1920s

Bayer heroin bottle

Near the end of the century, Bayer began selling heroin, a chemical derived from opium, for pain relief and cough suppression. Within one year, reports revealed that people were developing a tolerance to the drug. By 1910, Americans were crushing opioid pills and inhaling them for pleasure.

Four years later, Congress passed the Harrison Narcotics Act, making opioids available only by prescription.

“The original intent was not to limit the prescription of opioids for pain,” Meldrum said of the law. “It was to limit the recreational use of opioids, which had become a major problem in some areas of society. The Federal Bureau of Narcotics chose to essentially treat it as forbidding the prescription of opioids for almost any reason.”

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Me: Information taken out of context is dangerous. You cannot extrapolate outcomes from hospital controlled, time limited use for acute issues to long-term, chronic pain management.
Article: “In the late 1970s, researchers from Boston Medical Center analyzed the medical records of hospitalized patients who had received narcotics. They found that of 11,882 patients who received narcotics, only four showed “reasonably well documented” symptoms of addiction and only one “major” instance of addiction.
Jane Porter and Dr. Hershel Jick wrote a five-sentence letter to the editor in the New England Journal of Medicine describing the analysis in 1980.
“We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction,” the authors wrote. The letter was not a peer-reviewed study, and it described only patients under doctor supervision in hospitals.

“If you read [the letter] carefully, it does not speak to the level of addiction in outpatients who take these drugs for chronic pain.”

Dr. Hershel Jick, Boston University Medical Center

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Article:  “For years, the sole focus was on reducing non-medical use, reducing abuse,” Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing, told DrugRehab.com. “They were trying to stop kids from getting into grandma’s medicine cabinet. Nobody was asking ‘why does every grandma now have opioids in her medicine cabinet.’”


“The pain management field is still trying to find a way to effectively relieve pain without putting patients at risk for addiction. The country is still trying to find a way to reduce the number of people addicted to pain relievers without increasing the number of people seeking heroin.
In 2016, more than 2.1 million people were addicted to opioids, including 626,000 who were addicted to heroin, according to the National Survey on Drug Use and Health published in September 2017. About 718,000 people received treatment for prescription opioid addiction that year.”
But treatment doesn’t always lead to recovery. Between 40 and 60 percent of people relapse after receiving addiction treatment.”

Me: This tells me that:
1) Recovery form opiate addiction is outrageously difficult and it is better to not even take the risk,
2) MILLIONS upon millions of people have chronic pain,
3) More research is needed in non-drug and non-addictive drug therapies,
4) there is a tendency in life and in clinical research to seek out similar solutions, and this may be the direction the world is going with the current medical marijuana craze – that I believe may lead to very similar issues of massive levels of dependence and addiction and still unresolved chronic pain issues,
5) Back to old school solutions may seem oversimplified, but at some point we need to “Just Say No” to addictive drugs and “Yes” to treatment for addiction and “Definitely” to alternative modes of pain treatment with insurance coverage being expanded to cover them (which in the long term seems would be in the best interest of insurance companies as well – since addictions are expensive for everyone).

For source and to read the full article (as well as obtain other Addiction related resources) go here: https://www.drugrehab.com/featured/opioid-epidemic-causes/

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