A Pain-Drug Champion Changes His Mind About Opioids
Pharmaceutical companies are often accused of contributing to American’s overusing medications because of the companies’ ubiquitous advertising. But in a Wall Street Journal article, a 1990’s advocate of pain medication has done a 180-degree turn in his thinking, perhaps taking a bit of the blame for the ensuing prescription drug abuse epidemic.
Dr. Russell Portenoy, a pain management specialist at Beth Israel Medical Center in NY (in fact, he’s department chair), initially said that painkillers like Percocet, Vicodin, and OxyContin—all derived from the opium poppy—could help people with chronic pain, and the drugs grew in popularity. But now he says he went too far and he didn’t warn people enough about the risk of becoming addicted. Sounding somewhat guilty, he says “We didn’t know then what we know now.”
The drugs are notoriously more addictive than previously thought, and not always the best solution for long-term pain. Unfortunately, not all doctors know that the tide has turned among early proponents of using these drugs for pain management!
Initially, Portenoy was a key promoter of opioids beyond being used mostly for cancer pain, and he actually said, along with some followers, that there were few overdoses and less than 1% of users become addicted. He wasn’t just kidding when he said recently that if only we’d known then what we know now.
It’s heartening to hear him come clean about his possible part in the current drug epidemic. He didn’t have to speak the truth. But then he mentions some good that came of his promotion, attributing his mother’s relief from arthritis pain to her 15 years of hydrocodone use. It’s true that these meds help many people in the short-term and that not everyone becomes addicted, even with long-term use. Plus, pain is real and people in pain deserve relief.
But it’s frightening when one person, or a small group of people, wield so much power. People look up to their medical professionals and rely on them. Thank goodness for the movement in which patients are persuaded to take a more active role in their medical care and are more comfortable questioning their doctors.
It’s also frightening to learn what the drug companies did after doctors jumped on the bandwagon ofdangerously prescribing opioids. The article says that “In 1996, Purdue Pharma LP released OxyContin, a form of oxycodone in a patented, time-release form, and rivals followed suit.” It seems that they paid the price, though. “In 2007, Purdue Pharma and three executives pleaded guilty to ‘misbranding’ of the drug as less addictive and less subject to abuse than other pain medicines and paid $635 million in fines.”
Portenoy was also president of the American Pain Foundation in the 1990s; thus, he had a perch from which to spread his message. Also, he had relationships with over 12 companies that produce opioids, and justifies it by saying, and I paraphrase, they benefit his educational and research missions, and partially, his pocketbook – “without producing in me any tendency to engage in undue influence or misinformation.”
It’s hard to believe this stuff went on. This story is a blemish on the history of pain management.