The Federal Bureau of Narcotics was formed over 80 years ago in 1930. In 1954, President Eisenhower formed a council to battle narcotics use here in the United States. In 1971 President Nixon coined the term “war on drugs.” This was further strengthened by President Reagan in 1982. Overall, untold billions of federal dollars have been spent on this effort. Man did we get it all wrong.
We were spending our money and efforts at illicit drug use, while slowly building a society that not only condoned prescription narcotic drug use, but PAID FOR IT! Beginning at least in 2008, the number of deaths associated with prescription narcotic use exceeded those deaths caused by illicit drug use.
Codeine, OxyContin, Percocet, Vicodin, morphine, Xanax and Valium (these 2 are benzodiazapines–but frequently abused), Valium, Tramadol, Tylenol 3.
It never ceases to amaze me how quickly prescriptions for narcotic pain relievers are given out. In the ER it is almost a given. High likelihood in urgent care. Still far too common in a primary care settings.
And then there are the non-steroidal anti-inflammatory drugs (NSAIDs). Why should we throw something as safe and harmless as NSAIDs in with the narcotic drugs?
I firmly believe that, as time progresses (decades, probably) we will begin to understand just how dangerous this class of drugs is. Arthritis / joint damage, heart attacks, strokes, impotence, GI bleeds, disruption of intestinal barriers, dementia…this list of known effects seems to lengthen every month.
The problem here is that of sheer scale of use. Between over the counter use and the 70 Million prescriptions per year, it is estimated that there are 30 BILLION doses used per year. That’s with a “b.” Even uncommon side effects become magnified by this volume of use. Of course, bleeding ulcers, heart attacks and strokes are not uncommon, so the math just gets more complicated from there.
So what does all of this have to do with this particular article? This article looked at analgesic use after low risk surgery (gall bladder, cataract, TURP for prostate enlargement and varicose vein stripping) and what happens after 7 days and one year. The results were surprising:
- Opioids were newly prescribed to 7.1% within 7 days of being discharged from the hospital
- Opioids were prescribed to 7.7% at 1 year from surgery
- Instead of going down, the number of patients receiving a prescription for opioids at 1 year increased to 15.9%
- Overall, an opioid prescriptions within 7 days of surgery made it 44% more likely to be a long term user
- NSAIDs were prescribed to 0.3% within 7 days of discharge
- NSAIDs prescriptions jumped to 7.8% at 1 year from surgery
- Those taking NSAIDs within 7 days of surgery were almost 400% more likely to become long-term NSAID users
Wow. Talked about generating a society that is addicted to drugs. And while this study looks at low risk surgery, how similar would the numbers be for neck pain? Low back pain? Knee pain or headache? Makes me happy to be a chiropractor.
Again, I would ask…is the “War on Drugs” looking at the wrong side of the prescription pad?