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Too Many Too Many’s – Opioids

June 23, 2017 • Pain Science • Tim Flynn

As a nation when it comes to medical care we are thirsty in the rain.We frequently have too much medical care and not enough “health” care. With this backdrop we are launching a series entitled “Too Many Too Many’s” which focuses on the many areas of overutilization in our medical system. We are beginning the series with the obvious choice of opioid use.

Unless you have been totally free of any news media during the last year, you would be hard pressed not to realize the scourge that has been unleashed due to the creation, marketing and overprescribing of opioid medication.The statistics are staggering:

  • Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.
  • Every day in the United States, 44 people die as a result of prescription opioid overdose.
  • The U.S. claims less than 5 percent of the world’s population, but consumes over 80 percent of the world’s opioid supply.
  • In 2014, an estimated 467,000 adolescents aged 12 to 17 were current nonmedical users of pain relievers, which corresponds to 1.9 percent of adolescents.
  • In the 2013 and 2014 National Survey on Drug Use and Health (NSDUH), 50.5% of people who misused prescription painkillers got them from a friend or relative for free, and 22.1% got them from a doctor.The average age for prescription pain killer first-time use was 21 years of age.

The statistics alone are staggering, yet the ease of gaining access to prescription opioid medication is frightening.This past week I encountered another classic example of this epidemic in prescribing.The gentleman was an immigrant of Guatemalan descent who I happened to engage in a conversation with a few words and a lot of hand signals.He had broken one of his fingers that morning and the tape on his hand prompted me to ask what happened.He explained the mechanism of injury and that he had gone to the urgent care center where they had x-rayed his hand, taped it up and given him some medicine.He pulled a bottle from his pocket and said they also gave them these for pain.I asked him if he knew that these pills (Oxycodone) are addictive and dangerous.When I said “addictive” I noticed the micro expression of what appeared to be fear come across his face.As we continued to communicate it was clear that he had a history of alcohol addiction and that he now viewed these pills as indeed dangerous.I don’t have the rest of the story, but my hope is that a chance encounter may have prevented a downward spiral and another human being added to the sobering statistics.When it comes to opioids we have Too Many!

Tim Flynn

Dr. Flynn is board certified in Orthopaedic Physical Therapy, a Fellow of the American Academy of Orthopaedic Manual Physical Therapists and the American Physical Therapy Association, and a frequent presenter at state, national, and international meetings. Dr. Flynn is widely published including five textbooks, six book chapters, and over 85 peer-reviewed manuscripts on orthopaedics, biomechanics,...

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Jeff Yaver

Commented • June 23, 2017

Hi Tim, I can't agree with you enough on this matter. It is amazing how many of our patients continue to take these dangerous meds despite not truly getting any change in their symptoms over years. Addiction is a very serious matter for our patients and their loved ones.

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