Dreamland: RA & The Opiate Epidemic

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I simply completed an interesting e book in regards to the “opioid epidemic” our nation is at the moment embroiled in: “Dreamland: The True Story of America’s Opiate Epidemic” by Sam Quinones. Quinones, a journalist and former reporter for the L.A. Occasions, has meticulously researched the origins of America’s dependancy to opiates–from the explosion of “capsule mills,” and legally prescribed painkillers (the introduction of OxyContin particularly) within the 1990s, to Mexican black tar heroin that’s infiltrating quite a few U.S. cities at the moment–to assist others actually perceive why and the way this downside started.

As a persistent ache affected person who lives with critical ache every day, this subject impacts me personally as a result of I typically must depend on opiate painkillers for reduction throughout RA flare-ups. Over the last three years or so my RA has not been steady or well-controlled, which has mainly compelled me into going to a ache administration clinic to assist take care of the ache. The clinic requires all sufferers to actively take part of their multidisciplinary program: physician check-ups, bodily remedy, psychological counseling, and some other pain-related therapies (ex: set off level injections).

My opiate prescriptions are strictly managed and monitored via the ache clinic I’m going to as soon as a month. I’ve additionally signed a ache contract, which mainly lists a number of guidelines I must abide by with a view to proceed going to the clinic and receiving my hydrocodone prescriptions. If I don’t comply with them precisely, then I’m kicked out of this system and the clinic. I virtually suffered that destiny as soon as after I was prescribed cough syrup with codeine after I had the flu and I forgot to report it to my physician. Cough syrup? Sure, even that. I can bear in mind just a few years in the past when all my rheumatologist needed to do to refill my ache medicine was name it in to my pharmacy. These days are lengthy gone; now you could have the paper prescription in your hand and bounce via a bunch of hoops and purple tape to get reduction.

More durable opioid prescription pointers

I do notice why the medical occupation has turn out to be a lot more durable on handing out opiate prescriptions to sufferers currently; means an excessive amount of dependancy and abuse of those medication (Vicodin, Percocet, OxyContin) has occurred and continues to occur. Persons are dying in file numbers from overdoses.

In accordance with Quinones, “Overdose deaths involving opiates rose from ten a day in 1999 to at least one each half hour by 2012. Abuse of prescription painkillers was behind 488,000 emergency room visits in 2011, virtually triple the variety of seven years earlier than.”

One overdose loss of life each half hour?! All through the e book, Quinones writes extensively about how addictive and harmful opiate medication are and simply how widespread the dependancy downside is. The statistics of use, abuse, and drug-related deaths are staggering. Particularly disturbing is the prevalence of opiate customers who turn out to be hooked on prescription painkiller medicine after which start abusing heroin. The extra I examine these items, the extra anxious and disturbed I felt.

“Dreamland” is a fastidiously researched and gripping, page-turner of a e book, but it’s freaking me out considerably that I might be one Vicodin capsule away from taking pictures up heroin underneath a bridge. I notice how ridiculous this sounds and I do know I must relax, however in all seriousness, this nation-wide “disaster” is horrifying. It’s scary how shortly individuals can turn out to be hooked on this highly effective “morphine molecule,” as Quinones calls it. Mainstream media has additionally jumped on the story, spreading tales about the entire people who find themselves supposedly dropping like flies from taking some type of opiates.

In accordance with the Facilities for Illness Management and Prevention (CDC)’s web site:

“Previous misuse of prescription opioids is the strongest danger issue for beginning heroin use – particularly amongst individuals who grew to become dependent upon or abused prescription opioids prior to now yr. This means that the transition from prescription opioid non-medical use to heroin use could also be a part of the development to dependancy.

  • Greater than 9 in 10 individuals who used heroin additionally used at the least one different drug.
  • Amongst new heroin customers, roughly three out of 4 report having abused prescription opioids previous to utilizing heroin.”

Quinones offers comparable troubling statistics in his e book, so it’s no surprise I’m all of the sudden paranoid I’m going to finish up an addicted, arthritic junkie. I introduced up my considerations to my integrative physician at my final appointment, and he or she is somebody whom I actually respect and belief, so I really feel some reduction after our dialog. She listened fastidiously to my fears after studying the e book after which assured me that I used to be not an opiate addict or abuser. She additionally didn’t really feel I used to be in danger for dependancy based mostly on my adherence to dosage and participation within the ache clinic. She additionally is aware of that I’m an enormous worrier and helped carry me again to actuality a bit.

Nevertheless, regardless that prescription opiate ache medicine is one thing that I at the moment take, on and off (extra “on” currently), to assist ease a few of my RA ache, my objective is to utterly cease taking it someday within the close to future. Long run use of opiate medicine can pose threats to your well being apart from dependancy: tolerance, bodily dependence (not the identical as addition!), withdrawal, respiration issues, constipation, hyperalgesia (heightened sensitivity to ache brought on by opioids), despair, and others.

For extra normal details about opiate medication and their negative effects, take a look at the CDC’s web site: “Prescription Opioids” and a Q & A on opioids from the Mayo Clinic: “Mayo Clinic Q and A: Opioids for Therapy of Ache.”

My objective, together with that of my rheumatologist and all of my specialists, is to seek out the precise RA therapy to get my illness underneath management in order that I don’t must depend on prescription ache reduction. We’re at the moment nonetheless ready to see if my newest biologic, Rituxan, goes to do the job. Till then, I’m compelled to deal with steroid medicine (the evil prednisone) and the usage of hydrocodone as-needed.

The opiate epidemic or opioid disaster or no matter you need to name it’s certainly an actual and main downside on this nation proper now. I agree that security measures have to be taken to assist forestall much more individuals from turning into addicted, abusing, and overdosing on these medication. Nevertheless, I do not agree with persistent ache sufferers, reminiscent of myself, being stigmatized and criminalized after we genuinely want ache reduction. The primary and complicated problem proper now appears to be: How can we cease the over-prescribing and abuse of prescription opiates but not deny the sufferers who really want these medication for reduction? I hope somebody figures out this stability quickly, as a result of I’m getting uninterested in feeling like a legal and addict each time I simply want additional assist easing my ache.

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