#OurPain: The other side of opioids

LAS VEGAS - Millions of Americans who rely on opioid medications for pain relief are in anguish because of government pressure to reduce prescriptions across the board.

Doctors, pharmacists, and other providers have already made drastic cuts in the amount of pain medicine they dispense, with more cuts on the way. The actions are being taken in response to media reports about an opioid epidemic.

I-Team reporter George Knapp begins a week-long investigative project examining "The other side of opioids." 

Imagine diabetics being told they can no longer be prescribed insulin? Or cancer patients being told that chemotherapy is no longer an option? We Americans like to say we don't want anything coming between a doctor and a patient. But for tens of millions of chronic pain patients, there's an entire gaggle of middlemen who decide whether a patient gets medicine that a doctor has prescribed.

When Las Vegas mental health counselor Chad Broderick shot up a pain clinic before taking his own life in June, some media reports explained it as the actions of a drug addict. Those who knew Broderick say it wasn't addiction that drove him over the edge, it was pain.

An estimated 100 million Americans -- one in three -- have experienced chronic pain, that is, pain lasting longer than three months. Of those, as many as 30 million are now considered to be collateral damage because of the war against opioids.

"I've been through it all," said Barby Ingle, pain patient advocate. "Over treatment, under treatment, mistreatment, no treatment."

Barby Ingle was a cheerleading coach at a major university, ran her own business, was happily married. Pain took it all away.

"Every single aspect of your life. Physically, emotionally, spiritually, financially, it wiped me out."

Serious injuries put her in a wheelchair for seven years, which caused other painful diseases, including something called RSD.

"It feels like someone put lighter fluid on me, caught me on fire, and it's real difficult to put out," Ingle said.

Forty-three doctors later, she was treated with a powerful painkiller and got her life back. She now advocates for other pain patients who have, in effect, become opioid refugees.

"There is 100 million Americans and here in Nevada, approximately 980,000 chronic pain patients that need help. Opiates should not be taken off the table because there is media hype and hysteria," she said.

Opiates have been used by humans to control pain for thousands of years. Synthetic versions, opioids, are not appropriate for all pain patients but are a godsend for millions. That word, opioid, is now a staple of nightly newscasts, and the reports typically show pictures of prescription bottles and pain pills, implying that prescription drugs are responsible for an ever-changing number of deaths, 16,000 per year, 30,000, 100,000, the parameters and definitions have proven very flexible.

"I did a 24-hour study using Google News in May of last year, using one word -- opioid. I got 75 stories. Every story had some combination of epidemic, abuse, death," said Dr. Michael Schatman.

He is an internationally known pain expert who has spent much of his life getting patients off of opioids. He says the numbers used to generate anti-opioid hysteria are both exaggerated and distorted. In a paper he co-authored, he writes that the generally accepted base number, 16,000 opioid deaths per year, is largely the result of illicit street drugs, not prescriptions.

"I got some recent data from New Hampshire, that showed over a period of time, 80 percent of the opioid deaths was due to synthetic, non-pharmaceutical Fentanyl, China white, which is mixed with heroin. Because it is an analog of Fentanyl which is a prescription drug, it goes down as a prescription opioid death," Dr. Schatman said.

The states often cited as the deadliest for opioid OD's have seen huge increases in illicit Fentanyl. Nationally, Fentanyl deaths jumped 540 percent in a 3-year period. In western states, the illicit opiate of choice is still heroin, which is cheap, plentiful and far more powerful than in years past.

"Illicit Fentanyl and heroin are the drivers of overdose today. Those are illicit opioids," said Dr. Stephen Ziegler, Indiana University, Purdue University.

He is a social scientist, not a medical doctor. Ziegler has no dog in the opioid fight but bemoans what he calls patient abandonment, that is legitimate pain patients who are cut off from treatment because of deaths from street drugs.

"We're focusing on prescribers for problem that is significantly being driven by an illegal market," he said. "It's almost like we're arresting the wrong person, and when you do that, it's means the real suspects are still out there on the loose."

In Nevada, an opioid task force was created in response to numbers showing Nevada the top five for opioid prescriptions per capita. But Nevada isn't close to the top five for opioid deaths. In fact, opioid overdoses in Nevada have declined every year since 2011.

The only category with an increase is deaths from heroin. A closer look at the list of opioid deaths as reported by the county coroner show that nearly all of the deaths involve multiple substances including heroin, methadone, methamphetamine, cocaine and alcohol and many of the dead had serious underlying medical conditions. If there is any trace of an opioid in their systems, they are counted as opioid OD's.

"The study came out just this year, looking at the toxicology of people who died of supposed prescription opioid deaths. The average number of substances found in the system, including alcohol, amphetamines, cocaine, tranquilizers, was six. We're not talking about 16,000 opioid deaths. We're talking more like 1,600," Schatman said.

Millions of legitimate pain patients are now living in fear and anguish because they know that even if their doctors think medication will help them, the simply aren't going to get it.

Many have lost hope, and like Chad Broderick, have taken their own lives.

#OurPain additional resources where you can learn more about opioids.


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