Pain management's growing body count

The way we manage pain in this country is killing us.

An average of 79 people, many of them young, die every day from opioids, according to the Centers for Disease Control and Prevention. Approximately 30,000 people died in the United States in 2014 from opioid abuse. This is far from someone else's problem. And the numbers are only going up.

If you're thinking heroin, you'd be right. But if you think prescription pain pills are not as dangerous as heroin, you would be dead wrong. Heroin actually accounts for fewer than half of all opioid deaths, even with its widely varying purities and adulterants, the CDC reported. In fact, of the 28,647 people who died from opioids in 2014, the majority--more than 18,000--died from overdoses of prescription pain pills. The same pills many of us have left over after a surgery or injury and keep just in case. I know because I've kept them myself.

And just when we thought it couldn't get worse, we're seeing a spike in deaths caused by fentanyl, a synthetic opioid that's as much as 40 times stronger than heroin. Fentanyl is so potent that the equivalent of a few grains of sugar can kill. It's being mixed with heroin, unbeknownst to the user, and like heroin, pressed by traffickers into pills and capsules that are indistinguishable from the commercially produced version.

Although the United States accounts for only 5 percent of the world's population, we consume 80 percent of the world's opioid supply and 99 percent of its hydrocodone, according to the National Institute on Drug Abuse. More than 300 million prescriptions were written for pain pills last year in the United States, costing $24 billion, CNBC reported, and that's just for legally prescribed pills. In fact, since 1999, according to the CDC, the amount of prescription opioids sold in the United States has nearly quadrupled.

One other number has also quadrupled during that same time period: Deaths from opioids. Hardly a coincidence. More people died from drug overdoses in the United States in 2014 than from either motor vehicle accidents or homicide, the CDC reported, and opioids were by far the biggest driver of this statistic.

Local, state, and federal law enforcement, including my office, have been aggressively attacking the supply front of this battle for years. I won't insult anyone by suggesting that we're winning that war. We all understand that we can't arrest our way out of this problem, but law enforcement obviously has a vital role in drug enforcement. For our part, my office will continue working with our local, state and federal partners to vigorously prosecute gangs, cartels and other drug trafficking organizations who put these drugs on the street.

But we are also re-energizing efforts to take this fight to those health care professionals who are anything but. Those who divert legitimate drugs from their lawful, therapeutic purposes to illicit and deadly purposes, all in the name of money. These diverted pills not only cause more deaths than heroin, but they also fuel its demand because addicts frequently turn to the cheaper and more easily obtainable heroin when they can no longer afford or obtain prescription pills.

In fact, 80 percent of heroin users started abusing prescription pills first. Prescription pill abuse is the strongest risk factor for heroin addiction, the National Institute on Drug Abuse reported, making a person 40 times more likely to start using heroin. So, while these dirty doctors and pharmacists who divert pain pills for profit represent an extremely small fraction of our dedicated health care professionals, they belong in prison with the other drug traffickers, and we're on that.

The stark facts compel the conclusion that any solution lies in reducing demand. What can you do? It's simple, won't take long and will save lives, possibly someone you know. Reducing demand starts with a single person doing a single act to promote education and awareness.

John Parker is the U.S. attorney for the northern district of Texas.

Editorial on 09/25/2016

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