By Lynn Webster, MD, Guest Columnist
Have you heard the news about hyperalgesia? “This is the idea that opioid medication, instead of calming pain, might actually make pain worse,” says Stephen Martin, MD, EdM, an Associate Professor of Family Medicine and Community Health at the University of Massachusetts Medical School, who wrote a guest post for HealthNewsReview.
In his post, he points out that media stories such as these greatly worry him:
- Denver Post: CU Boulder study: Narcotic painkillers cause chronic pain,
- FOX News: Opioids may prolong chronic pain, study suggests,
- Washington Post: Opioid paradox: Could morphine use hurt as much as it helps by prolonging chronic pain?
- Forbes: Prescription painkillers may worsen and lengthen chronic pain
Dr. Martin agonizes over such biased media reporting because, like me, his greatest concern is the well-being of patients. He worries that reports like these about opioids could adversely affect patients.
In conjunction with the new CDC Guidelines, these reports may increase anxiety among some patients who are able to function with their medications but now, with good reason, they may fear that their access to painkillers will be tapered or discontinued “for their own good,” because the medication might “cause addiction,” or — and this is a twist the media has recently picked up on — because the opioids could “increase pain.”
As Dr. Martin points out, “The study [the media is referencing] involved rats that had sutures tied around their sciatic nerves. The sciatic nerve was tied and the animals were left in pain for 10 days. Then, the researchers administered morphine directly to spinal cords of these rodents for 5 days.”
He concludes, “The next time a patient of mine becomes a rat, has its sciatic nerve constricted with sutures, and asks for 5 days of morphine near its spinal cord 10 days later, maybe I’ll take another look at this study. In the meantime, I’ll tell my patients to ignore the unbalanced news coverage that the research spawned. I am not saying that hyperalgesia doesn’t occur, but I don’t think it is as evident as suggested by this rat study.”
“Urgent Opioid Public Announcement!” ~ Dr. Drew Pinsky
Then there’s Dr. Drew Pinsky‘s “urgent” public service announcement,” addressing the effects of rampant opioid addiction that has already claimed the lives of countless people across the world.” You can see it here.
The real shame is that you probably already have seen it because, as a TV personality, Dr. Drew has name recognition that encourages viewers and fans to tune in to hear his latest messages. They see him on television shows that feature his name as part of the title, and they trust him.
So when he makes a statement such as, “The United States represents 5% of the world’s population, and yet we consume 80% of the pain medication – medicine that was not designed to be used for longer than 2 weeks,” viewers tend to think that there must be something wrong with the fact that the U.S. prescribes such a high percentage of the medication.
What viewers must consider is this: there are many reasons why the U.S. has 5% of world population and consumes 80% of the opioids. The chief reason among them is people in most other areas of the world do not have access to opioids and die in tremendous pain:
- There are billions of humans outside the U.S. who are in daily agonizing pain, many of whom can’t get any opioids to ease the pain from their cancers.
- Even if other parts of world would provide opioids for only hospice and cancer patients, and for no other reasons, the U.S. would not consume anything close to 80% of the world’s opioids.
U.S.-based physicians may overprescribe opioids to some people, but clearly, most people in the world do not receive the benefit of opioid therapy to mitigate their suffering when they’re dying. Providing relief from intractable non cancer-related pain is not even a consideration in many other countries for economic reasons.
I hope Dr. Drew is not suggesting we move toward that position in the U.S. I refuse to believe he feels it is acceptable for hospice and cancer patients to die in excruciating pain. Dr Drew must believe that unbearable pain needs to be treated, even with opioids if no other treatment is effective.
As a celebrity journalist as well as a medical doctor, Dr. Drew has more responsibility to show leadership than others. This requires that he not promulgate spurious theories and fuel hysteria. I’d say his “urgent public service announcement” is particularly damaging because a trusted public figure should know better than to record a message of hyperbole that could do harm.
Biased Opioid Reporting Makes for Compelling Headlines
Since media consumers already fear opioids (with good reason, especially in the wake of the opioid-related death of pop star Prince and other high profile individuals), it’s tempting for journalists to tell viewers and readers what it expects to hear, wants to hear, or most fears hearing.
So media outlets’ ratings and advertising rates increase as they feed half-truths and out-of-context headlines to the public.
Sometimes, I wonder whether the media understands the harm that its actions can cause. I am sure Dr. Pinsky, as a physician, would never want to inadvertently contribute to misinformation. Unfortunately, his public service announcement may do just that. It could hurt, rather than help, the cause that we share: to help patients.
Lynn R. Webster, MD, is past President of the American Academy of Pain Medicine, Vice President of scientific affairs at PRA Health Sciences, and the author of “The Painful Truth.”
This column is republished with permission from Dr. Webster’s blog.
The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represent the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.