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The United States is in a Pain Pandemic

According to the Centers for Disease Control (CDC) in 2019, 20.4% of adults had chronic pain and 7.4% of adults had chronic pain that frequently limited life or work activities (referred to as high impact chronic pain) in the past 3 months. How are these pained adults treating their condition? Mostly with dangerous opioids, and with organ-damaging non-steroidal anti-inflammatory drugs (NSAIDs). 

In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses, according to the National Institute for Health. The abuse of and addiction to opioids—including prescription pain relieversheroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. 

How did this happen?

In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. Pain was known as the 5th Vital Sign beginning in 2001, and ordered to be assessed and treated liberally. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive. Opioid overdose rates began to increase. That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder (not mutually exclusive).

 

What do we know about the opioid crisis?

  • Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.

  • 8 to 12 percent of people using an opioid for chronic pain develop an opioid use disorder.

  • An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.

  • About 80 percent of people who use heroin first misused prescription opioids. {Here is your real “Gateway Drug”!}

 

So what is wrong with taking a prescription pain-killer opioid? 

Every dose has known side effects, such as drowsiness, mental fog, constipation, nausea, dependance, tolerance, slowed breathing / depressed respiratory drive.  The accumulation of taking these drugs regularly furthers the impact on the gastrointestinal system.  When the most expensive television advertising, Super Bowl commercials, include a drug to treat opioid-induced constipation, you know we have a problem. Their intention, originally as a powerful plant medicine derived from the poppy and now synthesized by pharmaceutical companies, is to treat severe and acute pain. They are not long-term tools, as the risks are quite high. 

 

War on Drugs

The famed “War on Drugs” was started June 18, 1971, an initiative led by the U.S. and expanded globally. Would you say this war has been effective? Among the effects are the criminalization of drug users, excessive levels of imprisonment, and punitive sentencing practices. The Penal Reform International states that “mandatory sentencing, the death penalty and enforced 'drug detention centers', are some of the unintended negative consequences of the 50 year 'war on drugs', a policy with direct impact on the vulnerable, poor and socially excluded groups, including ethnic minorities and women.”

In 2015, the Drug Policy Alliance, which advocates for an end to the War on Drugs, estimated that the United States spends $51 billion annually on these initiatives, and in 2021, after 50 years of the drug war, others have estimated that the US has spent a cumulative $1 trillion on it.  Money well spent? These are your tax dollars America. 

 

The Science of Addiction 

In simplified physiologic terms, the brain reacts to opioids with a feedback loop in the basal ganglia that includes a burst of the neurotransmitter dopamine which gives a pleasure response. Our brains are wired to recreate such pleasurable responses, and thus craves the repeat of that dopamine burst even at the sacrifice of health. This desire for more dopamine results in once-pleasurable activities now falling flat, then chasing more and more to achieve these neurotransmitter levels in the brain resulting in a tolerance. Furthermore, opioids act in the brainstem on respiratory drive centers, slowing vital function of breathing. 

pain and addiction

 

A Different Approach

So what can we do to treat pain, without enacting this insatiable dopamine loop? Cannabidiolic acid (CBDa), the non-intoxicating major cannabinoid made in the hemp / cannabis plant is not addicting, does not act on the basal ganglia – dopamine system, and has no effect in the brainstem on vital functions. But it does have natural selective cyclooxygenase-2 receptor blocking function to reduce / modulate inflammation. Perhaps the answer is in nature, harnessed beautifully with plant-based science. The collective human experience has pain. There IS a better way, harnessing natural relief in an inspired way is now possible. Healing without Harm.TM