Chronic Pain Fuels Boom in Opioids
By John Fauber, Reporter, Milwaukee Journal Sentinel/MedPage Today
Prescriptions for narcotic painkillers soared so much over the last decade that by 2010 enough were being dispensed to medicate every adult in the US around-the-clock for a month.
Fueling that surge was a network of pain organizations, doctors and researchers that pushed for expanded use of the drugs while taking in millions of dollars from the very companies that made them, a Journal Sentinel/MedPage Today investigation found.
Last year, the Journal Sentinel/MedPage Today found that a University of Wisconsin-Madison based organization had been a national force in helping liberalize the way opioids are prescribed and viewed. During a decade-long campaign that promoted expanded use of opioids -- an agenda that critics say was not supported by rigorous science -- the UW Pain & Policy Studies Group received $2.5 million from makers of opioid analgesics.
After that article was published last April, the UW Pain group said it had decided to stop taking money from the drug industry.
But the UW Pain group is just one link in a network of national organizations and researchers with financial connections to the makers of narcotic painkillers.
Beginning 15 years ago, that network helped create a body of "information" that today is found in prescribing guidelines, patient literature, position statements, books and doctor education courses, all which favored drugs known as opioid analgesics.
Without rigorous scientific evidence to prove that their benefits out weigh potential harm, drugs like OxyContin and Vicodin increasingly have been used to treat a wide array of chronic pain syndromes including low back pain and fibromyalgia.
Current practices reflect a gradual shift from the use of these drugs to treat short-term acute pain such as post-surgical pain, as well as severe pain associated with metastatic cancer or end-of-life pain -- uses that were based on solid evidence that such use was safe and effective.
But the benefit seen for those conditions was extended to treatment of chronic pain syndromes, an extrapolation that had no evidence to back it up.
Caught in the middle are millions of Americans with real pain that can last for years and thousands of doctors who want to help them.
It's a situation that was ripe for the influence of the pharmaceutical industry, said Mark Sullivan, MD, a professor of psychiatry and behavioral sciences at the University of Washington.
By 2010, those firms were selling four times as many prescription painkillers to pharmacies, doctors' offices and hospitals as in 1999.
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