Fredrickson: Focus on non-opiate painkillers to address the opiate crisis

Michelle Fredrickson

Editor’s Note: All opinion section content reflects the views of the individual author only and does not represent a stance taken by the Collegian or its editorial board.

This is a story about pain.

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I’m talking real, physical pain, in my case caused by a jarring impact that shoved my pelvis and hip bones into my sacroiliac joint in my lower back and the sciatic nerve. This is causing muscle stress and nerve pressure and putting me into serious, debilitating pain.

In an ordinary situation, a doctor might have prescribed me opioid painkillers. In my situation, that’s not possible. I’m deathly allergic to morphine, which means I’m probably allergic to all equally strong opiates.

When I’m in agonizing pain, this doesn’t seem like such a good thing. But when I read the statistics about the number of deaths in Colorado caused by prescription opiates, suddenly not being able to have opiates doesn’t seem so bad.  A possible solution to manage the number of opiates prescribed for pain is to produce more methods of pain control that are non-opiate.

More people die by prescription opiates – that is, drugs like Oxycontin and Vicodin – than by homicide in Colorado. This does not even include the heroin deaths.

It’s no secret that the opioid epidemic is real and scary. Doctors have to differentiate between real pain and drug-seeking behavior. Pharmacists have to know what to watch out for when filling a prescription. And every profession has a different idea of how to solve the crisis.

To break it down to the simplest level, opiates are highly addictive. Many people get hooked on them after needing them for legitimate medical pain, or for a chronic condition. My back problems will take up to a year to fully heal, and this isn’t an uncommon injury; that’s a long time to need painkillers.

From there, many people become heroin addicts simply because it’s cheaper to be addicted to heroin than opioid painkillers, and many more will die. The simple solution would be for doctors to stop prescribing opiate painkillers except when absolutely necessary to manage pain.

The problem with that is, there really aren’t that many other options. In states with medical marijuana, like Colorado, marijuana can be extremely helpful with pain management and has actually recently been shown to have reduced the number of opioid-related deaths. But the deaths are still unacceptably high, and this state-by-state solution won’t do much to help people in places where marijuana is illegal.

With the political situation the way it is, it is unlikely that marijuana will be legalized nationally anytime soon, and physicians are still reluctant to prescribe it.

We need more options. We need options that are not opiates.

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I found out I was allergic to morphine when I went to the emergency room with a rupturing appendix. The nurse said to me, ‘You look like you’re in a great deal of pain, do you want some morphine?’ And I responded, ‘Dear god, yes.’

They injected me with morphine, and that moment my throat closed. I couldn’t breathe. Hives erupted on my chest. Even though I was in agony, I sat up straight, completely panicking, trying to breathe. The doctor opened a drawer, took out an epi pen, and injected me with the adrenaline. Soon my airway opened enough that I could gasp in some wheezing breaths. ‘Well,’ the doctor said. ‘No more morphine for you.’ They clamped a bracelet to my wrist that said ‘SEVERE ALLERGY’.

I came out of the hospital the next day and the doctor gave me a prescription for Tramadol, which is widely regarded as the most effective non-narcotic painkiller. While still technically an opiate, it is generally tolerated better by people with morphine allergies than other pain medicines.

For moderate pain, the label on my prescription bottle said. It was, the pharmacist explained, a little stronger than Ibuprofen.

Well, let me tell you something. When you’ve just come out of surgery, ‘a little stronger than Ibuprofen’ just doesn’t cut it.

I asked for something stronger, but that’s the problem – there just aren’t stronger medications for pain that aren’t opiates. So I muddled through my days in quite substantial amounts of pain. The Tramadol took the edge off, but that was it, really.

I shelved the experience until this last week, when I found myself once again in debilitating pain and unable to take a medication that would really help me.

It occurred to me that the personal pain facing people with morphine allergies and the opioid crisis facing the country may have the same solution: Developing non-opioid painkillers that actually work for severe and debilitating pain.

It’s easy to tell doctors not to prescribe opiates, but without a good alternative, especially in states without medical marijuana laws, they don’t often have a lot of choice. Pain requiring opiates can be very debilitating.

Non-opioid painkillers often recommended are forms of anti-depressants that work very differently than opiate painkillers and are not nearly as effective at managing pain. There has been some research done at universities into new forms of painkillers that may be more effective, but none of these products have reached mass production.

Two major industries need to act to solve this problem. First, insurance companies need to stop restricting access to non-opiate options, which they do because the alternatives are usually more expensive. And second, the pharmaceutical industry needs to step up and work on these research projects if the opioid epidemic is going to be solved. Some of them have begun this process this year – but it’s taken them a long time, and this whole time they have been making a lot of money off of the opioid epidemic.

The opioid crisis is a huge problem especially in Colorado. Our legislators need to begin to put pressure on the pharmaceutical industry to develop non-opioid painkillers to give physicians a legitimate option that might reduce the number of prescription opioids on the market, and might begin to make a dent in the number of people dying that way.

Michelle Fredrickson can be reached at letters@collegian.com or online at @mfredrickson42