By Charlene Smith (c)
The study of pain, was, remarkably long neglected. But in the 1940’s a young Italian immigrant, John Bonica began studying pain management to assist the thousands of U.S. soldiers under his care in Washington State. After his wife nearly died during the birth of their first child he began examining ways to reduce pain in childbirth and developed the epidural analgesia, now used in millions of births. In 1953, he produced a classic script on the management of pain. “Bonica said pain is a disease by itself, not a disease prolonged,”
Professor Ahmed Ozturk, a pain expert from Huntington Hospital, West Virginia with three decades of pain management experience relates. “Bonica started the first pain clinics with the idea of getting people off drugs, he saw drugs as an impediment, rather than an aid to recovery. This attitude continued through the ‘50s but in the 1960s because of the liberal use of drugs and the arrival of methadone clinics attitudes began changing. Suddenly three out of four people would say they were addicted because of pain. Then in the 1990’s a group in New York mainly from Sloan Kettering [a cancer institute] developed the idea that chronic pain patients, like cancer patients, would benefit from opioid usage. They promoted high dose opioids for chronic pain patients. They promoted it cautiously, but once the genie was out of the bottle a great increase was seen in opioid usage, doubling almost every year in the 1990s, especially after the strong opioid OxyContin came onto the market.”
But there were other factors converging, the Diagnostic and Statistical Manual of Mental Disorders became increasingly influential in diagnosing new disorders that often coincided with new products from pharmaceutical manufacturers. The word ‘cure’ left the lexicon and ‘management’ of illness became the preferred term.
Then the Food and Drug Administration took the controversial step in 1999 of allowing prescription drug manufacturers to advertise over radio and television to consumers, the only other country in the world to allow this is New Zealand. Those ads have now replaced tobacco as by far the most lucrative form of advertising in the broadcast media. During his presidential campaign in 2000[i], President George W. Bush began suggesting the most radical changes to Medicare in six decades, the most notable of which was a powerful prescription drug clause. He personally drove it until it became law in 2003.
Ironically, perhaps, one of the countries the United States would go to war with in 2003 was Afghanistan a major producer of poppy, the plant from which opium is extracted. A decade of war has seen Afghanistan go from being a lowly opium producer to the worlds biggest and most successful opium producer. All these motley ingredients and more, fed into a pipe that would see prescription drug profits and addiction soar.
And so today we hear or know of pathetic stories of successful Americans who are hopelessly addicted to prescription opioids, or died because of their overuse, the roll call of deaths is long and includes entertainers Michael Jackson (propofol and the anti-anxiety drug, Lorazepam), Amy Winehouse, Heath Ledger (six kinds of painkillers), and New York Rangers hockey player Derek Boogaard (oxycodone). Those who admitted to being addicted and sought help in time include talk show host and political commentator Rush Limbaugh, actress Melanie Griffiths and many more.
Rapper Eminem[ii] confessed to taking: “Vicodin, Valium and Ambien, and toward the end, which caused my overdose, methadone. I didn’t know it was methadone. I used to get pills wherever I could. I was just taking anything that anybody was giving to me.”
