Because ,there are some150
million second class Americans victimized by chronic mental and physical pain.
Because , false alarms make it very
painful for people with chronic mental and physical pain to get relief for their suffering.
We can change this . Please
support my petition for equal rights.
Millions Victimized By
CDC’ False Alarm
Alen J Salerian MD
November 1, 2014
Millions of victims of chronic
mental or physical pain suffer needlessly because of misinformation about
opiates that govern medical practice.
According to the Institute of medicine some
120 million Americans suffer from chronic pain. This number does not include an
additional 30 million people with complex psychiatric disorders who may benefit
from opiates.
For many years CDC has been broadcasting
an epidemic of prescription pain medication overdose deaths. CDC statistics
suggest annually some 14,000 people or 3.5 people in a population of 100.000
die of overdoses from pain medications.
Our annual loss of 37,000 lives to suicide or 12 people per hundred thousand
population represent a robust indicator
of the human cost of untreated psychiatric conditions. Some of them may benefit
from opiates .Many of 120 million
Americans of chronic pain may also benefit from opiates. Access to opiates for therapeutic benefits
faces formidable challenges . But no challenge is greater than CDC false alarm of an epidemic of pain
medication deaths.
Opiates and evidence-based medicine:
Do
opiates help chronic pain?
Opiates are helpful for chronic pain (Goodman
and Gilman textbook of
pharmacology)
Do opiates have antidepressant
and mood stabilizing properties?
There is a plethora of evidence to support the
antidepressant and mood stabilizing properties of opiates.
A.
Endorphins are of central importance in pain,
impulse control, addiction and mood regulation (Nolte2012).
B.
There is high comorbidity among patients with
depression, addiction and chronic pain (Grant2004, Blair 2003).
C.
Postmortem data reveal people with severe
depressions have endorphin – morphine starved brains (Iseroff 1990).
D.
Clinical data support the mood stabilizing
properties of methadone (Pickar1979) oxycodone (Nyhuis2008) and buprenorphine
(Bodkin1994).
E.
Discontinuation of opiates many increase
mortality and suicide (Grant 2004, Kakko 2012).
F.
Opiates have been used as mood stabilizers since
ancient times (Weber –Emrich 1998).
Are
there opiates with low-risk of abuse?
In general long acting formulations of
morphine like substances ( slow absorption and long half life) have low abuse
potential(Salerian2010,Linores 2011). This is because they don't elicit
euphoria and their influence to promote drug seeking behavior is feeble. Methadone ,long-acting
oxymorphone and buprenorphine are common
examples of opiates with low abuse potential.
Do we
have an epidemic of painkiller overdose deaths?
CDC statistics show annual deaths from prescription
pain medication overdoses are 3.5 people per 100.000 population. In comparison
12 people die of suicide, 4 people die of motorcycle accidents, 4 people die of
drowning , 10 die of alcohol ,
The above findings suggest regular CDC warnings
of an epidemic of prescription
painkiller deaths is a false alarm.
No crises seems to justify our super vigilance to victimize
millions of Americans with chronic mental and physical pain.
References:
1.
Grant BF Stinson FS et al. The prevalence of
substance use disorders and independent mood and anxiety disorders. Archives of
Gen. psychiatry. August 2004 volume 1, PP 807 – 816.
2.
Kakko J ,Svanborg D K ,Kreek M J Hellig M .One
year retention and social function after buprenorphine assisted relapse
prevention treatment for heroin independence in Sweden: in randomized, placebo-controlled
trial. The Lancet 2003 volume 361, issue 9358, pages 662 – 668.
3.Apkarian AV Sosa Y Sonty S Levy
RM Harden RN Parrish TB Gilelman DR .
Chronic pain is associated with decreased prefrontal and thalamic gray matter
density. The Journal of neuroscience,
2004 – 24 (46) 10401 – 10415.
4.Webster RL Dasgupta N. Obtaining
adequate data to determine causes of opioid related overdose deaths. Pain
Medicine 2011;12:S86-S92.
5.Libby R. Criminalization of
medicine. 2008 Praeger publications.
