The 'big mistake' of painkillers

Aug 11, 2013

They’re supposed to kill pain, but they could be hurting patients more than helping them. This week on “Take Care,” we talk to Barry Meier, a New York Times reporter and the author of A World of Hurt: Fixing Pain Medicine’s Biggest Mistake, about painkillers in the medical field.

Click 'Read More' to hear our interview with Barry Meier.

Oxycodone, the primary ingredient in oxycontin, was originally used for cancer pain, end-of-life pain and pain after surgery. In the 1990s, it was discovered that these drugs could be used to help chronic, non-cancer pain like back injuries, arthritis and headaches, and that’s when doctors in the United States started prescribing them widely, said Meier.

“These drugs, while they do work well for some people, do not work well at all for many others and may have very serious consequences associated with them,” Meier said.

Up until the ‘90s, pain was treated with shorter-acting pain medications, like Percocet and Vicodin, Meier said. Patients were also sent to multi-disciplinary pain clinics where they used physical therapy, behavior modification and psychotherapy to help them live with the pain rather than get rid of it.

When oxycodone use started to increase there was minimal research behind its addictive properties, according to Meier.

“The basis of it was actually some very, very flimsy science,” Meier said.

Meier said that in most cases, oxycontin simply stops working for people, yet they are afraid of the pain they will endure if they were to stop taking it. He said it can create a medical condition known as hyperalgesia, so that the upping of the dose doesn’t make a difference and the patient ends up in more pain.

Besides that, Meier said that often people begin to “opt out of life” after long-term use of the drug. A study in California conducted in 2008 showed that workers with back injuries who took high doses of painkillers were out of work three times longer than those who did not. It also suppresses sexual hormones in both men and women.

Oxycodone was once seen as cheaper, about $7,000 a year for the pills compared to over $15,000 for multi-disciplinary programs, Meier said. But now, addiction programs, drugs given to treat addiction and drug screening have driven up the true cost of these painkillers substantially, says Meier.

At the moment, there are no alterative drugs that have been proven as effective as oxycodone, however, studies by the Mayo Clinic show that non-drug pain therapies can be just as effective, Meier said.

But many of these alternatives are not covered by health insurance. Meier believes those concerned with this problem should push government agencies and insurers should cover other forms of pain relief more often -- to help fix what he calls pain medicine’s biggest mistake.