Sunday, May 6, 2012

Painful Medicine

"OxyContin: Purdue Pharma's painful medicine"

My son was the first one to bring  the above article to my attention a couple of months ago.  I guess it's funny how they get to know your soap box issues. The craziest thing about this important health article is the magazine in which it was published: Fortune.  The article outlines how pharmaceutical companies like Purdue Pharma deliberately targeted primary care doctors like myself to get us feeling more comfortable prescribing potentially dangerous narcotic drugs.  Their sales team figured out that if they could suddenly have 20,000 family doctors prescribing their medication instead of say 2,000 specialists, they would hit the jackpot. That's exactly what they did.  Their profits shot through the roof.  OxyContin generated $3.1 billion in revenue in 2010.  That is nearly 3 times what they made in 2007, when the company plead guilty to a federal criminal count of misbranding the drug "with intent to defraud and mislead the public," and paid $635 million in penalties.  Sounds like the company made a pretty good financial gamble to me. I guess they can let the doctors like myself  deal with the thousands, if not millions of victims in their wake. Trust me, unless your doctor is collecting $100 cash for your 3 minute visit to assess your pain, they probably aren't the one making out like a bandit.

Narcotic pain medicines are very useful drugs.  After all, if you get filleted like a fish for a major operation, or are suffering from a painful cancer, you may very well need some Oxycontin.  However, the power of  these drugs is their ability to change the very way your brain functions.  It is not an uncommon occurrence for a person to start needing pain medications leading up to a hip replacement surgery and then long after their hip should have healed, their brain and body's dependence on the narcotic has only increased.  This has led to the high profile and everyday addicts most of us are familiar with.

I decided some time ago that as a general rule, I do not prescribe narcotic pain medications.  My patients that require chronic pain management are referred to a pain management center.  Some of them have ongoing pain that is difficult to treat.  Others have a physical problem that is being treated with the pain medication, but the problem might not be pain, but the dependence/addiction itself.

It should really enrage doctors and patients alike to read an article like this and make that connection between their behavior and the fat-pockets of business-savvy pill peddlers.  Every person who has found themselves in this quandary should demand answers from the regulators, the drug companies, and the physicians who, ultimately become the front line "tool" that is used to ensnare the public.  As physicians, we have to be more aware that people are selling a product with a dollar value on it based on our prescribing habits.  We should always carefully weigh whether the benefit to the patient warrants the risk to them, their families, and society as a whole. This applies not only to narcotic medicines, but all medicines, including antibiotics.

As patients, try to remember that it is hard work to maintain your health, with or without medications.  There is no easy way.  If you want the best chance at a life free of disease, without swallowing a fist full of pills every day, it is going to take a major shift in thinking and lifestyle.  The improvement you see will be directly related to the degree that your lifestyle is transformed.  I truly believe that our bodies have the potential to heal themselves, but I don't yet fully know how to do this.  One thing I know for sure is that the answer lies in a proper way of eating, thinking, feeling and behaving.

Please comment to share your experiences with these medicines or people who have become dependent on them.

Peace & health,
Dr. Safiyya

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