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More than 33,000 Americans were killed by opioids in 2015, and nearly half of them involved a prescription for the drugs. Each day, the U.S. Centers for Disease Control and Prevention (CDC) notes, 91 Americans die from an opioid overdose, and the numbers keep rising, nearly quadrupling since 2015.1 Knowing that these drugs carry the serious risk of addiction, abuse and overdose, they should be prescribed sparingly and only for the most severe cases of pain, for which no other options are available. More than 33,000 Americans were killed by opioids in 2015, and nearly half of them involved a prescription for the drugs. Each day, the U.S. Centers for Disease Control and Prevention (CDC) notes, 91 Americans die from an opioid overdose, and the numbers keep rising, nearly quadrupling since 2015.1 Knowing that these drugs carry the serious risk of addiction, abuse and overdose, they should be prescribed sparingly and only for the most severe cases of pain, for which no other options are available. Instead, they are often prescribed widely to treat milder cases of chronic pain, such as that from osteoarthritis or back pain. "In the past decade, while the death rates for the top leading causes of death such as heart disease and cancer have decreased substantially, the death rate associated with opioid pain medication has increased markedly," the CDC noted. "Sales of opioid pain medication have increased in parallel with opioid-related overdose deaths." It's shocking that, in the midst of this epidemic of opioid overdose deaths, the pharmaceutical industry would still be making payments to physicians to prescribe more opioid products, but this is precisely what's occurring, according to a study published in the American Journal of Public Health.2 1 in 12 Doctors Being Paid by Drug Companies Marketing OpioidsUsing the online Open Payments Program from the Centers for Medicare and Medicaid Services, you can easily search to find out what (if any) payments your doctor has received from the pharmaceutical industry, along with the nature of the payments. The researchers used Open Payments to reveal opioid-related payments to physicians between August 2013 and December 2015. More than 375,000 non-research opioid-related payments were made to more than 68,000 physicians, totaling more than $46 million. This amounts to 1 in 12 U.S. physicians collecting money from drug companies producing prescription opioids. The top 1 percent of physicians received nearly 83 percent of the payments, and the drug fentanyl, a synthetic opioid that can be anywhere from 500 to 1,000 percent more potent than morphine, was associated with the highest payments. Many of the states struggling with the highest rates of overdose deaths, such as Indiana, Ohio and New Jersey, were also those showing the most opioid-related payments to physicians.3 Also unsettling, family physicians received the most payments (close to 1 in 5 family medicine doctors was a recipient4), which is "an indicator that opioids are being really heavily marketed for pain," Dr. Scott Hadland, the study's author, told The Washington Post.5 "The next step is to understand these links between payments … and prescribing practices and overdose deaths," he said. "It's very common that the first opioid … [many people are] ever exposed to is from a prescription."6 Overprescription of Opioids a 'Fundamental Cause' of the Opioid EpidemicA Harvard study, "The Opioid Epidemic: Fixing a Broken Pharmaceutical Market," explains that the overprescription of opioids was, and continues to be, a fundamental cause of the opioid epidemic, noting that such prescriptions rose 104 percent from 2000 to 2010.7,8 In 2015 alone, the report noted, about 300 million prescriptions for opioids were written, which is more than one for every U.S. adult. While pharmaceutical company payments to physicians may play some role in this overprescribing, the Harvard report suggests the surge in prescriptions can be traced back to the widespread prevalence, and undertreatment, of chronic pain. This, in turn, spurred a campaign for more aggressive pain management. It's true that many Americans struggle with unaddressed chronic pain but, unfortunately, most doctors are ill-equipped to treat it. As a result, they resort to the only treatment they know: prescription drugs. It wasn't long ago — during the 1980s and 1990s — that many prominent physicians and health organizations urged the use of opioids for chronic, noncancer pain, even going so far as to state that the risk of misuse and addiction was low. The game-changer occurred in 1995, when Purdue Pharma received U.S. Food and Drug Administration (FDA) approval for extended-release oxycodone (Oxycontin) for the management of moderate to severe pain. The company launched an extensive marketing blitz surrounding the drug, including doubling its marketing team and paying $40 million in bonuses, offering free initial supply coupons to patients, and hosting "all-expenses-paid pain management and speaker training conferences at lavish resorts" for clinicians. The drug became a blockbuster, in large part due to non-rigorous patenting standards and lack of policing of fraudulent marketing, the report notes:9 Purdue's success was attributable in part to low patenting standards that enabled the company to secure and extend market exclusivity for extended-release oxycodone, providing motivation for its aggressive marketing. Taxpayer Funds Will Now Be Paying Drug Companies to Fight Epidemic They CreatedBefore President Trump declared the opioid epidemic a public health emergency on a federal level,10 six states had already taken matters into their own hands and declared it as such, in some form or another. Doing this allowed them to access certain resources that might otherwise have been out of reach outside of a declared emergency. In some cases, such as in Arizona, the emergency declaration allowed for increased funding, which the state has used to train law enforcement officers on how to administer naloxone, the lifesaving opioid antidote.11 In Massachusetts, the emergency declaration made a prescription monitoring program mandatory for physicians and pharmacies, while also allowing first responders to carry naloxone. The sad irony is that taxpayer funds will now be paying drug companies for naloxone, another one of their products. So Big Pharma gets richer off the epidemic they created, leaving U.S. taxpayers to pay the bill. As the price of naloxone rises, so do the reported sales and profits of the companies providing the drug. Amphastar, the primary provider of injectable naloxone to emergency personnel, reported net revenue of $77 million in the last quarter of 2015.12 As recently as the early 2000s, the cost of naloxone hovered around $1 per dose. Today the drug costs close to $40 per dose and the price keeps rising.13 Apparently, Big Pharma is taking full advantage of the race to get the medication in the hands of all first responders and even into most households. Meanwhile, in 2016 the federal government proposed adding $1.1 billion in the 2017 budget to expand prescription drug and heroin abuse treatment and make naloxone more available.14 The funding included millions to help individual states treat opioid abuse as well as to fund 700 health care providers within the National Health Service Corps, but ignored the many ways the government itself enabled the opioid epidemic. Leftover Pain Meds After Surgery Fuel Opioid EpidemicOpioids are frequently prescribed to treat post-surgery pain, but rather than individualizing prescriptions according to a patient's needs, some surgeons use a one-size-fits-all approach.15 The result, according to a study published in JAMA Surgery, is that 67 percent to 92 percent of patients report having unused opioids after their surgical procedures.16 "Unused opioids prescribed for patients after surgery are an important reservoir of opioids available for nonmedical use and could cause injuries or even deaths," the researchers noted, pointing out, "Rates of safe storage and/or disposal of unused prescription opioids were low." Leftover drugs could be taken by teens or other family members, posing an overdose risk, for instance. These addictive and potentially deadly drugs are even being prescribed to women who have just given birth, putting them and their children at serious risk. One study in Obstetrics and Gynecology revealed that more than 1 in 10 Medicaid-enrolled women filled a prescription for an opioid following vaginal delivery to treat post-delivery pain.17 Fourteen percent of them then went on to fill a second prescription within six to 60 days after delivery. Separate research has shown that 1 in 300 women who fill a prescription for opioids following cesarean delivery go on to become persistent users.18 A second study revealed that young children of mothers prescribed opioids were at a significantly increased risk, by 2.5 times, of overdose.19 Among children, 1 in 10 of overdoses occurred in infants under 1 year, while half occurred in children 2 years or younger. Ohio County Morgues Overflowing With Opioid Overdose VictimsIn Montgomery County, Ohio, an area at the crossroads of distribution for black market opioids, an estimated 800 people are expected to die in 2017 due to opioid overdose — more than double last year's number. CNN reported:20 Most nights, the freezer in Montgomery County's morgue is stacked floor-to-ceiling with bodies. Dr. Kent Harshbarger, the coroner whose office services more than 30 counties, estimates that 60% to 70% of these corpses are the result of an opioid overdose. 'What's most challenging is seeing the same story repeated over and over again,' he said. 'It seems, from my perspective, inevitable.' West Virginia, meanwhile, which has a $2 million annual budget to provide funeral assistance for families who cannot afford them, has been overwhelmed with funerals for the past five years, driven in part by the opioid epidemic. In 2017, the program was nearly out of money four months before the end of the fiscal year.21 Opioid Deaths May Be UnderreportedWhile it's clear that opioid overdose deaths have reached epidemic proportions, research published in the American Journal of Preventive Medicine found that such deaths may actually be underreported.22 Many death certificates do not identify the specific drug involved in the death, which results in an underestimate of the involvement of specific drugs in fatal overdoses, the study found.23 "For instance, mortality rates calculated using imputed data on specific drugs where such information was lacking on death certificates suggest that in 2014 opioid- and heroin-involved death rates were understated by more than half in Pennsylvania," the researchers wrote. In all, when death certificates were corrected, they found mortality rates related to opioids and heroin were 24 percent and 22 percent greater than reported, respectively. According to the study:24 Current death certificate data are problematic for understanding the drug poisoning epidemic, with a particular issue being the frequency with which no specific drug is identified. This results in an underestimate of the involvement of specific drugs in fatal overdoses (but not in the overall number of drug fatalities), which is sometimes substantial. Safer Options for Overcoming Chronic PainEven when taken as directed, prescription opioids can lead to addiction as well as tolerance, which means you need an increasingly stronger dose to get the pain-relieving effects. People of all ages and from all walks of life are being affected, and please understand that anyone can become addicted to opioids. So, if you have chronic pain of any kind, know that there are many safe and effective alternatives to prescription and even over-the-counter painkillers. The pain remedies that follow are natural, providing excellent pain relief without any of the health hazards that pain medications often carry.
Dietary Changes and Additional Pain Relief OptionsWhen physicians don't know how to effectively treat chronic pain, they often resort to prescription drugs, which will do nothing to solve the underlying reasons why you're in pain. Toward that end, if you suffer from chronic pain, there's a good chance you need to tweak your diet as follows:
Finally, the natural pain-relief methods that follow are useful for ongoing and lasting pain relief and management:
 Help Support Mercury-Free DentistryFrom August 20 through August 27, we launch the seventh annual Mercury-Free Dentistry Week. Hidden from us for too long is this stark fact: Mercury, the most toxic and volatile of the heavy metals, is the main component of dental amalgam (also called, incorrectly, “silver” fillings). Alternatives to amalgam are available in any dental office, and every consumer should demand a nontoxic, non-polluting alternative. We believe in inspiring progress — and nowhere is the progress more evident than the work of Consumers for Dental Choice and its Campaign for Mercury-Free Dentistry. The sole mission of Consumers for Dental Choice is to end the use of mercury fillings. In the year ahead, with your help, Consumers for Dental Choice will continue to fight to break down any barriers necessary so all consumers have access to mercury-free dentistry. Resources to Help You Locate a Mercury-Free DentistYou don’t have to wait for FDA to act to protect your children and you. Find a mercury-free dentist who recognizes the danger of mercury fillings and provides non-mercury fillings today! Charlie Brown and I both urge you: Go only to mercury-free dentists! Don’t give a dollar of your money to any dentist who puts mercury in the mouth of ANY child. The following organizations can help you find a mercury-free dentist in the U.S. and, in some cases, internationally:
Three Ways You Can Help the Campaign for Mercury-Free DentistryConsumers for Dental Choice and its team have made amazing progress toward mercury-free dentistry. But there's still hard work ahead as Consumers for Dental Choice is now breaking barriers which limit consumer access to mercury-free dentistry, forcing federal and state government agencies to be accountable and organizing briefings for governments around the world. There are three ways you can help Consumers for Dental Choice succeed:
 Sources and References1 U.S. CDC, Understanding the Epidemic 2 American Journal of Public Health August 8, 2017 3, 5, 6 The Washington Post August 9, 2017 4 STAT News August 9, 2017 7, 9 Harvard Law & Policy Review, Volume 11 8 Your News Wire July 27, 2017 10 Fox News August 11, 2017 11 Scientific American August 9, 2017 12 Huffington Post March 23, 2016 13 Equities April 26, 2016 14 Newsweek February 2, 2016 15 Reuters August 2, 2017 16 JAMA Surgery August 2, 2017 17 Obstet Gynecol. 2017 Mar;129(3):431-437. 18 Am J Obstet Gynecol. 2016 Sep;215(3):353.e1-353.e18. 19 Pediatrics February 2017 20 CNN August 6, 2017 21 The Washington Post March 7, 2017 22, 24 American Journal of Preventive Medicine June 2017 23 Time August 7, 2017 25 Springerplus. 2013; 2: 56. 26 Annals of Internal Medicine January 3, 2012 vol. 156 no. 1 Part 1 1-10 27 Archives of Internal Medicine 2012 Sep 10:1-10 [Epub ahead of print] By Dr. Mercola
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