A Pained Life: False Narratives About the Opioid Crisis

By Carol Levy, PNN Columnist

The common belief that any patient who takes opioids for pain relief soon becomes addicted seems to have started in 2003, when The Orlando Sentinel published a front-page series under the headline "OxyContin Under Fire: Pain Pill Leaves Death Trail.”

The newspaper used the term "accidental addict" to describe patients who "put their faith in their doctors and ended up dead, or broken."

This characterization quickly became the go-to description for most news articles on the emerging “opioid crisis.” An innocent person, often a teenager on the cusp of life, suffers a painful injury. Their doctor prescribes OxyContin or some other highly addictive opioid and their lives are forever changed. They take higher and higher doses, become addicted, and die from an overdose.

Four months after publication, the Sentinel printed a correction. Two patients profiled in the series as “victims” were not newcomers to opioids, as they had been portrayed. They were using illegal drugs and abusing prescriptions long before their first dose of OxyContin. The Sentinel series also grossly overstated the number of overdose deaths that were caused solely by oxycodone, the active ingredient in OxyContin.

The problem was that the presentation of someone falling so far so fast due to prescription opioids remained irresistible to the media. It became the common narrative, especially in “recovery” stories about someone becoming addicted due to thoughtless opioid prescribing by a doctor or dentist.

This helped create the false belief that people in pain become addicted, very quickly and easily, to opioids. The lie took hold, even though a 2008 study found that chronic pain patients taking opioids had a rate of abuse and addiction of only 0.19% — less than one percent.

In 2015, another study was released that reinforced the false narrative. People in chronic pain on long-term opioid therapy had a “misuse” rate between 21 to 29 percent; and their addiction rates averaged between 8 and 12 percent.

Those are horrible numbers. And very misleading. Shortly after the study was published, the researchers admitted they may have exaggerated the potential for addiction.

“We agree that opioid use is not inherently risky, most patients seem to use opioids without misuse or addiction,” said lead author Kevin Vowles, PhD, a Professor of Psychology at the University of New Mexico.

But that kind of clarification we do not hear in the news. Instead, the story is still about patients prescribed opioids becoming addicted and fueling the opioid crisis.

Often ignored by the media is that opioid prescriptions have been declining for a decade and that most overdoses are cause by street drugs. Or that medical students now get more training in pain management. This may actually be the best and safest time to prescribe and receive opioid prescriptions. 

Most of us bemoan and rant against the CDC opioid guideline, and because many of our doctors feel intimidated by the DEA and state medical boards, fearing arrest and prosecution if they prescribe opioids. 

Maybe, though, the place we need to start is with the media, and getting them to tell the true narrative: most pain patients do not become addicted. 

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 30 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.