The Modern Marketing of Pain
September 2, 2008
This is a guest editorial post written by our newest contributor, Larry Golbom R.Ph MBA of the Prescription Addiction Radio show. We encourage comments from all viewpoints in this discussion.
How The FDA Has Failed the US Since the Introduction of Oxycontin
Compassion is a marvelous human trait. We read of disasters and human tragedy on a regular basis followed up by the outpouring of sympathy, money, fund raisers and, if necessary, food, medical aid and supplies. A day doesn’t go by that we read or hear of a story that affects our emotions. For many of us, “if we were rich, we would never have any money”, because of the human conditions we wish we could be a part of resolving.
The drug companies have become ingenious at tapping into our emotional traits. As a result, modern medicine has too many times become modern marketing that exploits our basic fabric of caring. Since I started the radio show, I am repeatedly accused of “not understanding pain”. The criticism of the radio show not caring about people in pain is a repeated mantra by individuals who are associated with the pain management industry. Additionally, most published articles written around the country negatively reflecting the opioid drugs will bring personal criticism implying that a critic of the over production and over marketing of the powerful and deadly narcotics is lacking in concern for our fellow human being.
The pain management industry and drug companies, for a number of years, have not overtly supported a drug data base so desperately needed in our state of Florida, but we are to believe that they care about the reportedly 40 to 90 million people in pain ( a moving number depending on who is being quoted). In Florida, Medical Examiners in 2007 reported thousands who died with a narcotic prescription drug in their body. The silence on the deaths is deafening from the critics who accuse others of a lack of compassion concerning the use of the drugs.
The truth of the numbers of people in pain, at best, are suspect. In summary, the best way to avoid pain is to not turn over 50 years old. The number of people in true need of the deadly, addictive and dangerous opioids is highly exaggerated by the pain management mavens and their minion who don’t want to admit that they would go through severe withdrawal if they would go more than 24 to 36 hours without the drugs they support. The original source of the pain is seldom treated and the painful and severe withdrawal is delayed. Family members watch helplessly as their loved ones continue to live in denial and slowly deteriorate before their eyes. Honesty in the discussion of the opioid drugs and the destruction they are creating is never done in an open forum. The pain management industry would be hard pressed to defend the marketing and use of the drugs past the terminally ill, acute situations and specific medical conditions that research has proven that there is no other alternative. The “black and white medical situations” for the proper use of the opioids is clear and the number of “gray area medical situations” is limited.
In my opinion, the legal profession has made some grave errors in presenting the damage and destruction the opioids have created. The argument always pertains to “pain” and not to the inherent dangers and historical data pertaining to the products being derived from the opium plant. The legal profession continues to walk into a dark hole they cannot get out of when they immediately capitulate to the term the drug companies created, “Painkillers”. Before the drug companies began to market and sell “the painkillers”, oxycodone, hydrocodone, fentanyl and methadone were dangerous narcotics.
Opioid drugs are dangerous and deadly. That is where the conversation must start. There is no question that the opioids are necessary in specific medical conditions, however, the mismanagement, over production, over marketing and misuse of the drugs by the medical professionals should be where the discussion begins. “Painkiller” is a marketing term and does not convey the true nature of the dangers of the category of the drugs. The FDA, in a court, would be helpless in defending their silence on the dangers of the opioids. The number of deaths from methadone, oxycodone, hydrocodone, fentanyl, etc. continue to mount by the FDA’s own record keeping and their silence, since 1996, will be remembered by historians as one of the biggest debacles in the over 100 year FDA history.
My apologies to those who believe I am not a compassionate individual, but not to those who refuse to have an honest discussion about the increasing opium epidemic our country is experiencing led by the direction of the legal drug manufacturers and with the blessing of a government agency who has apparently lost control to the pharmaceutical industry.
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20 Responses to “The Modern Marketing of Pain”
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Finally, the truth. A factual and well written article by an extremely compassionate and courageous pharmacist who is trying to right the wrongs of the greedy pharmaceutical industry and their bedfellows. Had we been told the whole truth about these pills — that they are from the same chemical family as Heroin and mimic the same effects — the Drug companies would not be enjoying such huge profits.
Thank you Larry for clearly defining the problem. It is high time for the medical community to focus on the destruction these prescribed narcotics are causing and collaboratively implement proper safeguards and strategies to protect the public….and for our government to ensure it.
The public’s widespread casual use of these “painkillers” is unbelievable. For instance, tell a co-worker you have a headache, and they will offer you one of their prescription opioids (which everyone knows is illegal). I’m not saying these people are addicted, nor am I saying they are criminals. It is simply too easy and too accessible due to the unconscionable prescribing of these drugs by unscrupulous doctors who don’t care about the consequences to those who either are addicted or who are prone to addiction. The problem is, most people don’t know they have a problem until they are in that deep, dark hole that could take years (if ever) to escape. There are supposedly legitimate doctors who actually send out mail advertising if you bring in your old pill bottles and $200 CASH, they will gladly give you what you want. Thank God, many of these “pill mills” have been busted. PLEASE, if you are aware of such operations, inform the authorities (Mayor, Sheriff’s Department, Governor, DEA, EVERYBODY and ANYBODY that can do something about it). I agree that there are legitimate reasons to prescribe and use painkillers, but it has to be controlled and monitored more closely. If not, our nation will become one of ZOMBIES who do not feel pain, but do not feel anything else, either.
Larry wrote what many of us who work with the people so harmed by the drug companies feel, the greed of the drug companies and certain MD’s are destroying people in the name of profit–not anything else. To say that these drug dealers have any concern about you and me is ludicrous.
No, instead of treating the cause of pain they just want it to continue because that means they make more money. Do they care that they are making people so dependent or addicted to the drugs that they have to go to a place like ours to withdraw? No, again the only thing that counts is money.
Steve Hayes
Director
http://www.novusdetox.com
According to a report I just read “The rate of deaths in Florida caused by prescription drugs is over three times as high as the rate of deaths caused by all illicit drugs combined.” This is from Florida’s Annual Report on Drugs Identified in Deceased Persons.
This should serve as a wakeup call to every citizen, just how pervasive “legal” drugs are in our society and how they are killing people. It’s time to educate the public now on the dangers of legal drugs.
Sheryl Letzgus McGinnis, Author
This is one of the most well written articles I have read in some time. Larry addresses the reality of the epidemic in this country and world wide, opiate dependency and accessability. Narcotics are a multi billion dollar industry which has led to marketing scams that have been accepted by those responsible for the distribution of these dangerous drugs.
We have become a pill popping nation because it is socially acceptable. Unfortunately, we have also become a society who has grown to have a dependency to use and abuse these drugs to function on a daily basis. If a child can not sit still in class or focus on their work immediately they are often labeled as ADD/ADHD and we drug them. If a person both young and old has issues with life we put them on antidepressant to ease reality. It takes little verification to ones need for pain relief and now we have a wide spread epidemic of narcotic use and abuse.
So who are the experts here? The ones that should know the pitfalls of these practices are the ones responsible. This trail leads to the drug companies who knowingly produce lethally, addictive products and minimize the dangers. Even our own government has their hands in the cookie jar by allowing this corruption to continue from both a state and federal level.
Until something is done more will be become dependent, addicted and even die. Leaving many of us to wonder why this is so out of control and has greed truly over powered the moral values of a human life.
Nancy Garvin
Mothers Against Medical Abuse. Org
Help Stop Rx, Methadone Deaths and Abuse
In the guestbook of my website are THOUSANDS of death and addiction stories and many of these stories start with a valid prescription for opiods for moderate pain. The overmarketing is directly to blame for this and the FDA needs to reclassify the more lethal doses to get them off our streets and preventing doctors from starting uninformed patients on the road to addiction and possibly death.
Larry Golbom has written an excellent article summarizing many of the major problems behind the national epidemic of prescription opioids. In regard to the ‘pain management’ industry we need to ask for answers to a vital question in order to find the truth about chronic pain and who the really ‘compassionate’ people are: Why has this ‘industry’ failed to understand the dimensions of chronic noncancer pain, including the vast differences between the types of chronic pain, the importance of proper diagnosis, the influence of psychological co-morbidities, and the variety of non-opioid treatments which truly help the vast majority of chronic pain patients? If it had, only then could it claim to be ‘compassionate’ to people in pain, rather than continue to blame others who rightfully criticize the excessive, non-selective use of these powerful, brain-active narcotics with all their documented tragic and lethal outcomes.
A very well written, and very truthful article.
The human suffering and toll these deadly narcotics have, and continue to take on our society is alarming. Given the nationwide death and addiction statistics, it is beyond any comprehension as to why the FDA does not take immediate action to reclassify most, if not all, of these dangerous drugs.
Thank you Larry.. for putting in simple words the very serious and deadly problems we face with prescription drugs, Big Pharma, our medical professionals and the way society perceives these very addictive and dangerous drugs. Since being involved in the fight against prescription drug addiction I have been overwhelmed with the number of people affected by this epidemic; Friends, family, co-workers. Most of these people had no idea they would end up addicted to the medication their own doctors precribed for them and still do not recognize they have a problem. It is so very sad that the FDA does not function as intended; to protect and keep from harm the citicens of our Country, but instead are controlled and run by Big Pharma and the billions of dollars in profits they receive from the sorrow, misery and death of those affected by these deadly drugs.
To my regret, I did not understand how deadly prescription painkillers were, until my son, Andrew died of an Oxycotin overdose on 8-15-08. I learned that he was getting the pills from his eighteen year old girlfriend who was supposedly diagnosed with endimitriosis. I cannot understand why a doctor would prescibe such an imature girl, weighing lest then 100 lbs, such a potent drug. She was also being prescribed Norco and Vicodin, in addition to numerous psychotripic medications. The word painkiller is correct in that they kill, but we, the family are left with insurmountable pain. I will not let my son’s death be in vain and vow to fight the drug company, doctors, pharmacies and others who contributed to my son’s death.
Living in sorrow,
Drew’s mom
Once again, Larry says it just the way it needs to be said! The truth is that we are dealing with a modern day plague, thanks to the big pharms!
Some of us will continue along every day and fight for change, some will just simply stick their heads into a big black hole in the ground, ignore it and hope it goes away………….
Just when will the FDA get their head out of their big black hole??????
Thank you Larry.
Larry, is just projecting one angle, albeit a relevant one. But what Larry should point out in a debate there is always two sides. This medication is assisting people in positive ways. I understandstand that some doctors are not ethical, but for the majority that are, they must be doing something correct as there are plenty of positive stories relating to this situation.
I am sure Larry could come up with statistics for alcohol deaths through abuse, Illiceit drugs, smoking, obesity, steroids etc….but Larry is choosing to target one sector without providing the positives that these types of medications provide.
Abuse of anything will kill.
Well written Article, but very one sided.
Brock Landers also needs to expand his focus. There are many medical studies that refute any long-term effectiveness/benefit of prescription opioid drugs and demonstrate a high incidence of addiction/abuse in those patients taking them for chronic, moderate pain not attributable to a specific disease process, which is the vast majority of pain patients. There are two problems with his equating legitimate opioid pain meds with “alcohol, illicit drugs, smoking, obesity, etc: first, morbidity/mortality from the latter group requires MUCH greater quantities and amounts of time than with opioids (one OxyContin can kill you!); second,people’s decisions on use of prescription opioids are HUGELY influenced by MISLED, MISINFORMED (by the drug companies) physicians. At least the liquor and cigarette makers are forthright about the dangers of their products!
Kirk, to fully understand what you are saying, it seems that you are dismissing that opioids do assist people. As well when any medication is dispensed, a detailed sheet is given with the medication that includes side effects and benefits. I dont feel that abuse of one substance such as food or alcohol vs drug abuse should be downplayed due to the time frame it takes to terminate the abuser. I would assume, that licened doctors that do perscribe opiates for long term cronic do have some idea what they are doing. The issue in this whole case is that the minority (the few that abuse and cannot control themselves) vs the majority of cronic care patients that follow the rules and want to have a good quality of life.
Brock, you are making some assumptions here which are not consistent with what is actually occurring in our failing healthcare system. First, when it comes to prescribing opioids, sad and tragic as it may seem, many “licensed doctors” do not have “some idea of what they are doing”, because, rather than err on the side of caution, they have chosen to believe the hype and sales pitches of the opioid manufacturers and their ‘opioid management enablers’. Second, it has never been shown that long-term opioid therapy frequently leads to a ‘good quality of life’; in fact recent research studies are showing the exact opposite, in addition to the mounting toll of lives addicted and terminated. Lastly, few patients with legitimate pain set out to intentionally abuse opiate painkillers; the more common scenario is the patient who has been prescribed a powerful opioid for a minor injury or condition and for a longer time than appropriate, and then becomes addicted, which may then result in loss of control and abuse. Who ultimately bears responsibility for this excessive, unrestricted opioid script writing? Look around, its happening all over– my 20 year-old-daughter was given a 30 day supply of Percocet after having her wisdom teeth removed, which she then had enough common sense to immediately dispose of. Tragically, too many people, young and old, have not been as well educated as she has been about the dangers of opioids.
Stephen, I understand your opinion. However, you are taking the minority stance on this. Many more true chronic pain patients have gained positive benefits. As I reread the article, it seems to focus on the minority. Stephen and Kirk, I am sure both of you could agree that a few bad apples have always ruined the bunch. In this case, the minority of the people that abuse are trying to dictate for the majority that do follow prescriptions properly. If the government decided to close McDonalds restaraunts to curb obesity, there would be a huge public backlash. I am sure the FDA has not recalled opiods is purely due to the fact the benefits to the mass supercede the abusers that choose to have no self control.
Brock, this is the last I will say about this. I believe we differ in what you call “positive benefits” of long-term opiod use. Aside from the hundreds of thousands of people who have died from prescription opioids and those who have discontinued them because of side effects, there is a distinct minority of patients who benefit from opioids by relief of documented intractable tissue-dervied pain, while the remaining much larger majority are either dependent or addicted to these drugs, including those in whom their original pain has long ago healed. Most of these people are dysfunctional both physically and mentally, and often seek disability. Unless an addicted person admits to his/her addiction and voluntarily seeks drug detox and rehab, they usually believe that they need their opioid agent to ‘relieve pain and to function’, which is the nature of addiction [with opioid use 'for life' unless they can be tapered off their drug or enter a detox/ rehab program]. Now if you believe that this state of chemical dependency which is so common in our healthcare system today is a ‘positive benefit’ of chronic opioid use [especially when compared to a drug-free lifestyle], there is no further explanation I can give.
Stephen, I will also speak one last concern on your opinion. I honestly believe that your opinions are just that, opinions. I am amazed that you feel that your thoughts on this subject are superior to the FDA or the US Surgeon General. The abuser will always abuse. The patient that follows direction will enjoy positive benefits. If a patient is required to take anti inflamatories day to day, they too are dependant on a drug, if a patient requires blood pressure medication, they too are dependant on a drug. Now if any of these drugs are abused, they will kill the patient. I do not feel you should utilize your status as an MD to block a group of people as abusers. I challenge you to research this topic then respond to the situation.
Mr Landers
I have witnessed the lively debate between yourself and the respected doctors who have taken the time to respond. I have long waited for an open discussion on the use of the opioids for chronic pain. Since you have come forward as an expert on the use of opioids for chronic pain, please come on the radio show and express your opinion. As far as falling back on the FDA or U.S Surgeon General for reference, please bring the recent documentation that supports the research and studies that have been used for what you determine to be “positive benefits”. Up to this point, I have not been able to find an individual from either organization to appear on the show. As you should be aware, the documentation used to promote the opioids for chronic pain has been from short term use. The increase in disability claims, addiction and deaths from the opioids would not support your assertions.
The limited use of opioids was well stated within my article and, if you recall, the article was based on the responsibilities of the individual and company who distributes the products. I believe addiction and the misuse of the drugs by the individual is better served in another forum. This dialogue is predicated strictly on the responsibility of the practioner and drug manufacturer.
Please come on the radio show and discuss the documentation and studies that support your statements. First statement: “The patient that follows direction will enjoy positive benefits”. The reality of dependence and severe withdrawal by individuals does not warrant that claim. Another statement by you: “Many more true chronic pain patients have gained positive benefits”. Again, the documentation and statistics for long term use, in a generalized statement,does not support your statement.
Please contact me via http://www.prescriptionaddictionradio.com. I welcome your presence on the radio show to help clarify the benefits of opioids for long term chronic pain, except in rare situations. You are welcome to bring any other “experts” or individuals to join you. It is time for this discussion to take place on the radio show!!!!! Larry Golbom Prescription Addiction Radio - Breaking the Silence
Larry, I have not even heard of your show until this point in time. You have two MD’s responding to myself disspelling any truth to any benefit of opiod use. I have placed the challenge to them to research the situation rather than place there personal opinions on the line. By stating that all licened practitioners that dispense opiods for long term use are either not educated or have fallen for a great sales pitch of the pharmacutical companys is either ignorant or biased opinion. None of these are fact. When Stephen Gelfand stated ” Most of these people are dysfunctional both physically and mentally, and often seek disability”, He is making a generalized statement that paints every patient with a legitimate illness as outcasts. Larry you tried to make a point by stating “In Florida, Medical Examiners in 2007 reported thousands who died with a narcotic prescription drug in their body.”What you neglected to state was the reason why these people died. A statement like this resembles a great headline, but carries no substance. Explain how many of these thousands of people died due to the drugs in their bodies, this may carry some relevance and possibly support your point, but by throwing a number out without validation is unresponsible journalism. Larry I do agree that opiods can be dangerous when abused, but as I previously stated so are many other things such as food, smoking, drinking..etc. If you want to debate this on the radio, I would be happy when you get representation from all sides on the program, not the biased group of so called experts that I am sure you can deliver.