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Addiction to painkillers, the kind that are prescribed such as oxycontin, or illegal, such as heroin, is on the rise in the United States.
While a recent report from Nevada says cases of overdoses are on the decline, that is not the case for heroin. Heroin overdoses rose from 19 in 2010 to 52 in 2014. And for years, Nevada has ranked near the top in the number of deaths from painkiller overdoses per 100,000 people.
That’s the backdrop for a recent decision by the federal Centers for Disease Control.
The CDC was all set to release a new set of guidelines in two weeks for prescription painkillers.
Then, it changed its mind.
Now the CDC will do something it has never done before. It is holding public hearings, and taking comments online about its proposals.
The question becomes: what does the public know about addiction that scientists who study addiction don’t?
And does it even matter, especially in Nevada?
Las Vegas Doctor Mel Pohl has treated those with opioid addiction for decades. He has also authored last year’s, “The Pain Antidote,” which prescribes managing pain rather than drowning it out with drugs.
"I think it's absurd that a governmental agency that's based in science that looked at the scientific data and came up with a proposed set of guidelines is now being subjected to this really reactionary response that has frankly been somewhat politically and economically motivated," Dr. Pohl said.
He said many people have come to believe that painkillers are the only way for them to control their chronic pain; however, Pohl said studies have shown that people using opioids over the long term do not see an improvement in function or ability to live their lives.
"Here we're looking at a very emotional response of people who suffer chronic pain and who have been mislead to believe that this is a good solution," he said.
Dr. Andrew Kolodny, senior scientist at Brandeis University; current chief medical officer at Phoenix House, a drug addiction treatment center, has no doubt pharmaceutical companies who profit from American's opioid addictions are behind the delay by the CDC.
"This is not something the CDC wanted to do," Dr. Kolodny explained, "The CDC wanted to release its guideline in January. The reason they opened up the docket is because they were pressured to do so by industry-funded organizations."
He said the opioid manufactures see the guidelines as an economic threat. According to Kolodny, the pharmaceutical companies have seen profits from opioids soar over the past several years and new guidelines could threaten that profit stream.
Dr. Kolodny believes the reason there is an epidemic of painkiller use is doctors started aggressively prescribing opioids without knowing the risks of addiction.
"Most of the prescribers were acting with good intentions, they were responding to a brilliant marketing campaign that mislead the medical community about the risk of putting patients on opioids medicines long term, especially the risk of addiction was minimized," he said.
He said many doctors are eager for the new guidelines as a way to push back against patients who are pressuring them to write more prescriptions.
According to Kolodny, many patients feel like the CDC is trying to "take their painkillers away from them." He said those patients believe the opioids are helping them, when in reality, many are actually harmed by the painkillers.
"Some of these patients truly believe these opioids are helping them, because when they don't take their opioids they're feeling pain and discomfort," Kolodny said, "Whether that means the opioid is really treating their pain, or whether the opioid is treating withdrawal pain is difficult to say."
He said the general public doesn't realize that opioids have the same impact on the brain as heroin. He believes if they did, they would have a different reaction to guidelines.
"If the public and the prescribers understood that these were essentially heroin pills, they would be in favor of much more cautious use," Kolodny said.
Dr. Mel Pohl, author of “The Pain Antidote”; Dr. Andrew Kolodny, senior scientist at Brandeis University; current chief medical officer at Phoenix House, a drug addiction treatment center.