Alternative Medicine Is Not the Answer to the Opioid Epidemic
America's opioid epidemic is not manufactured hype; it's real. Prescription painkillers are now more widely used than tobacco. Opioids were to blame for 31,000 overdose deaths in 2015, a 300 percent increase from 1999. Of the top ten drugs involved in overdose deaths, half are prescription opioids.
How did we get here? Many have offered coherent, convincing narratives. Pharmaceutical companies are the villains in one story, pushing their pricey products on doctors and patients to drive their booming business. In another tale, Americans are growing increasingly stressed and overworked, and then self-medicating with powerful anesthetics to cope. Both narratives have merit.
But well before these stories could play out, prescription opioids came to prominence based on shoddy science. As pediatrician and science writer Paul Offit detailed in his book Pandora's Lab, heroin was originally offered over-the-counter when it was launched in 1898. Pharmaceutical company Bayer based the decision on a single study, which followed a handful of subjects for less than a month. The architect of the study and creator of heroin, Heinrich Dreser, concluded that the drug was completely non-habit forming.
Over the next few decades, that spurious finding would be disproved by real-world data in the form of rampant addiction and death. Heroin was banned in the United States in 1924.
More recently, Dreser's missteps would be repeated by pain specialist Russell Portenoy. In 1986, he argued in a paper published to the journal Pain against medicine's "opiophobia." Citing stories of 38 people using high-dose painkillers, he contended that "opioid maintenance therapy can be a safe, salutary and more humane alternative [for] patients with intractable non-malignant pain and no history of drug abuse." Using poor science, Portenoy would propel Oxycontin, the brand name of the semisynthetic opioid oxycodone, to its infamous position as the most prevalent and abused prescription painkiller.
"If you're going to medicate a nation, at the very least you should base your recommendations on a mountain of evidence, not a molehill," Offit writes.
Yet many doctors, health practitioners, and patients are now advocating that we make the same mistake again, this time with alternative medicine techniques like chiropractic and acupuncture. However, the fact that these techniques are, unlike opioids, non-habit forming, does not make them good remedies for pain. There's a "mountain of evidence" that says otherwise.
Bad science paved the way for mainstream medicine to force addictive opioids upon vulnerable patients, so it's flabbergasting that professionals are suggesting and embracing bad science to fix the problem. Instead, better to finally grapple with the genuine causes of the chronic pain epidemic driving millions to medicate on pills: obesity and overwork. Unfortunately, diet, exercise, and rethinking work in the United States have proven to be bitter pills to swallow.