As overdoses surge, doctors are cutting back on prescribing opiate painkillers—at the cost of those who actually need them.
As a young woman, Cindy Laux developed a toxic relationship with alcohol. It was after her very first sip, she recalled, that she fell under its spell. Laux described the moment as though it was love at first sight.
Such a powerful response led Laux to sober up at just 22 years old. She went the traditional route: attended 12-step meetings and sponsored other women along the way. She became a fixture in her Southern California recovery community—a person upon whom fellow recovering friends could rely.
While working as a nurse in the intensive care unit, Laux broke the fall of a heavy patient, and injured herself in the process. After nearly a decade sober, at 31 years old, Laux was prescribed opioid pain relievers for her injury.
“The first time I took opioids it didn’t give me the same feeling as alcohol,” Laux said, during an interview with The Fix. “There was no euphoria, no float-y feeling—just some pain relief.”
Her response to alcohol was nothing like her response to opioids, she said, debunking a common myth for people in recovery that all drugs lead you down the agonizing road of addiction. Once an addict always an addict, a common phrase in the recovery community, turns out not to hold up for everyone.
But Laux’s injuries didn’t stop there, nor did her prescriptions to opioids.
After numerous back surgeries, Laux developed adhesive arachnoiditis, a rare condition typically brought on by too many medical procedures. The result is chronic, intractable pain. A searing hot sensation, like a gunshot wound, shoots up and down her body. She says at times it feels like her skin is on fire.
“I went from going to meetings and helping others to being bed bound,” said Laux. But opioids offered her some relief, and also a semblance of a real life, one in which she could be there for her family and friends while remaining active in her recovery community.
These things, she said, keep her going.
But her quality of life dramatically changed when Americans began to overdose from opioids in record numbers.
Overdose deaths from painkillers have quadrupled in just 12 years. From 1999 to 2014, over 165,000 people have died in the U.S. from opioid overdoses, according to the Centers for Disease Control and Prevention. Such startling figures necessitated action by the federal government. The result of that action—namely, rolling back the number of painkiller prescriptions—has left patients like Laux in a precarious position, fearing for their future and ability to remain on opioids to treat pain.
“I was a star patient,” said Laux, describing her status in a California pain management clinic. “I had gone from using a walker to hiking every morning in the hills with my dog and friends.”
Being active in the world, something most of us take for granted every day, is critical for pain patients, Laux said.
But while overdoses surged month-by-month, Laux’s doctor began to scale back her dose of opioids. “I asked him why every month for six straight months,” she said.
Finally, after months of asking, the doctor provided Laux with a straight answer. Laux said he told her, “Apparently, people are dying.”
Indeed people were (and still are) dying. Every 19 minutes a life is lost from an opioid overdose.
But patients like Laux and several others interviewed for this story insist they are not the ones contributing to the tidal wave of overdoses across the country. They cannot understand why they are the ones bearing the brunt of new policies aimed at reducing mortality rates by federal and state efforts to scale back opioid prescribing.
Last March, the U.S. Surgeon General wrote a historic letter addressed to all prescribers, urging they exert caution when prescribing opioids to their patients. Days later, Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), published a letter of her own addressing the plight of chronic pain patients on opioids.
“Although the exact numbers are not known,” Volkow wrote, “the majority of people with opioid use disorders are not pain patients and did not start that way.”
Indeed, the most recent surveys from the Substance Abuse and Mental Health Services Administration (SAMSHA) show over half of misused opioids are not prescribed by doctors. That same survey found that out of the 97.5 million people prescribed to painkillers during 2015, only 12.8 percent misused them.
Other studies have shown that addiction (not physical dependence) in chronic pain patients who take their medication as prescribed, is rare.
“The risk of addiction in a pain patient new to opioids with no history of substance abuse or psychiatric illness is tiny,” said Dr. Howard Fields, who holds doctorates in neuroscience and medicine from Stanford University, and is the founder of the University of California San Francisco Pain Management Center.
Furthermore, the number of chronic pain patients who die from an overdose while in treatment is also rare. The most recent study found that out of 39,449 patients on opioids for longer than three months, only 59 of them died from “opioid-related causes.” Read more “the fix”…