The United States is being overwhelmed by an epidemic of addiction to prescribed synthetic opiates such as OxyContin, hydrocodone, Percocet, Lorcet, Lortab and Vicodin. What should be done? The quick answer: Take the profit out of pain.First, there should be additional pain drug education for all doctors and a whole new curriculum for any doctor who would be allowed the privilege of prescribing potent, addictive pain medicine. Second, health education in middle school should pound home the message that just because a doctor prescribes a drug, does not mean it is "safe." Furthermore, the fact that perception of pain is a matter of mood and context must be taught. (Childbirth pain, for example, will be experienced differently by supported mothers when the baby is wanted compared to isolated single moms who are unhappy to be pregnant.) Third, scientific research for promising nonaddictive pain medications should be funded, and when effective reasonable cost substitutes for the synthetic opiates are found, the addictive medicines should then be banned. In March 2007, for example, ScienceDaily.com reported that scientists came up with UFP-101, which "avoids many of the side effects of morphine, currently the 'gold standard' in pain reduction." Given that drug firms will not even admit - until circumstances force them to - that their drugs are addictive, banning an existing pain-relief drug will be a tall order. Fourth, drug companies which market addictive medications must be required to package them in the least addiction-creating ways possible (e.g., time-release patches rather than pills) and in ways that are difficult for criminals - who would repackage the active ingredient in a way that will create addiction - to tamper with. Fifth, allow practitioners of effective alternative pain treatments to practice. Three proven alternatives are acupuncture, hypnotism and micro-electronic implants. Of course, any practitioner of anti-pain arts should have to prove, to some extent at least, that their practices do indeed work. But, having provided such proof that should be it - no further barriers to practice (promoted by now- mainstream practitioners) should be allowed. Sixth, encourage skepticism about the (mostly for-profit) pain- industrial complex. Scientists may love to split hairs about what "really" constitutes addition, but for-profit drug companies have no bottom-line reason to cooperate. Indeed, addiction obviously increases sales. Doctors can keep many patients content by merely prescribing "happy pills," and established detox and treatment centers do not want to close their doors. There are combined approaches to manage problems with addictive substances that society has decided should be legal. Cigarettes and liquor, for example, are subjected to advertising and age-use restrictions. There are a variety of programs to counter illegal addictive substances, such as crop eradication and border guards to interrupt smuggling routes. Now, without question, alcohol and nicotine kill and incapacitate many, many people, and black market cocaine and heroin activities flourish. But, however expensive or ineffective such prevention efforts may be, they do exist and they are scrutinized and evolving. By contrast, so far, efforts to control synthetic opiates have been limited to reclassifying some of them as Schedule II drugs (Schedule I being the most dangerous). There is, in fact, no multifaceted approach to handle this ballooning problem. Such reclassification, welcome as it may be, is not nearly proportionate to the problem. Recently the Gazette reported that Toyota was reluctant to expand in West Virginia because those whom they might employ would be addicts. It was also reported that West Virginia ranks high in births of babies whose mothers were addicted to prescription drugs. PainMedicationAddiction.org reports that unintentional deaths from prescription opioid analgesics now outnumber such deaths from cocaine and heroin combined. That was not so a decade ago. Palmer is a retired business and economics professor.
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