Opioid painkillers: Responding to a growing problem

April 25th, 2016

A head-scratching Super Bowl ad

Of all the buzz-worthy Super Bowl advertisements this year, one left a lot of people scratching their heads and also stepped into controversy by highlighting a growing trend in prescription painkillers. The quirky black-and-white ad featured a man suffering from opioid-induced constipation who was envious of the people and dogs around him who were clearly not suffering from this problem. The ad never mentioned a product name, but it did put a spotlight on a problem many people may not have known existed.

The growing use of opioids for dealing with chronic pain is now significant enough to spawn a companion industry to deal with the side effects. What are opioids, and how did they reach this level of attention? What are the dangers of opioid painkillers and related drugs? And how might churches and people of faith respond?

What are opioids?

The use of opioids to manage pain has an extensive history. Morphine has long been used to deal with severe pain. Codeine is another familiar drug that is often prescribed for milder pain. Other drugs in this class include hydrocodone, oxycodone and methadone. According to the National Institute of Drug Abuse (NDIA), the drugs work by reducing “the intensity of pain signals reaching the brain” and also affect brain areas that control reactions to painful stimuli.

The other thing that we have long known about opioids and their pharmacological cousin, heroin, is that these drugs have significant side effects and risks. Among those risks are drug tolerance, physical dependence, addiction, and overdose. Constipation is also a possible side effect, but it’s overshadowed by these potentially much more serious issues. This is what prompted more than head scratching from those concerned about the risks.

A growing epidemic

“Next year, how about fewer ads that fuel opioid addiction and more on access to treatment?” White House Chief of Staff Denis McDonough tweeted on the day after the Super Bowl, according to USA Today. The strong reaction of the administration was fueled by an awareness of the growing problems associated with opioid painkillers. The Centers for Disease Control and Prevention (CDC) calls it an epidemic and reports that more people died from drug overdoses in 2014 than in any year on record. A growing percentage of those deaths are related to opioid use. The CDC says 78 Americans die from opioid overdose every day.

Some of the increase is associated with abuse of heroin, an illegal drug; but “the majority of those overdoses involve legal prescription drugs,” President Obama said in a visit to Charleston, West Virginia, in October. As reported by The New York Times, Obama also said, “More Americans now die every year from drug overdoses than they do from motor vehicle crashes.”

Even though there hasn’t been a change in levels of pain that Americans report, the CDC says doctors are prescribing opioids at a rate four times greater than in 1999. Part of the reason for the increase may be that opioids are effective and easy. According to an article on the online news site Mic, “Patients want them because they provide a more immediate effect than exercise or dietary changes.” The article goes on to note that while Americans make up only about five percent of the world’s population, we consume 80 percent of the world’s opioids.

A government response

“The situation is so dire that we had to do something,” Dr. Carl R. Sullivan, the director of addiction services at the West Virginia University School of Medicine, told The New York Times. Sullivan was speaking in the wake of several new government initiatives to address the opioid epidemic. The Obama administration has requested an additional $1.1 billion to focus on treatment, overdose prevention and reducing the illegal sale of drugs.

The CDC has also issued new guidelines for prescription of opioids, which recommend that doctors initially prescribe ibuprofen or aspirin for pain and limit opioid treatment for short-term pain to three days. “The urgency of the epidemic, its devastating consequences, demands interventions that, in some instances, may make it harder for some patients to get their medication,” The New York Times reported Dr. Nora Volkow, director of the NDIA, as saying. Volkow continued, “We need to set up a system to make sure they are covered. But we cannot continue the prescription practice of opioids the way we have been. We just can’t.” The current practice has made opioids the most prescribed drugs in the nation and has created a $2 billion industry to provide them.

Being all that God calls us to be

At a March 29 forum, President Obama acknowledged that there’s still a moral stigma attached to those suffering from addiction issues. He also referred to his own life and said that he had known friends who struggled. They “were not more morally suspect than me,” he said.

The Reverend Caesar Rentie believes that the church can see beyond the brokenness of lives to the redemption God intends for all people. “The Church has to respond to anything that keeps us from being all that God calls us to be and it needs to be a spiritual response even though it manifests in physical ways,” the former Chicago Bears football player notes. Rentie, who now serves as the Celebrate Recovery pastor for First United Methodist Church in Mansfield, Texas, and as the vice-president for pastoral services at Methodist Health System, says, “The folks who are struggling with this are Christians and are in our pews.” Others find their way to the church to experience a true community.

Rentie believes in the healing power of Christian community. He refers to a TED Talk by journalist Johann Hari, who researched addiction issues. In the talk, Hari tells about an experiment in which a rat was put in a cage with two water bottles, one of which was laced with heroin. The rats chose the heroin water over the regular water and, if left alone, died very shortly thereafter. But when the experiment was redone with rats who were in a communal environment where they had plenty of food, stimulation, and friends, almost none of them chose the heroin water, and none overdosed.

If two rats together are stronger than one, perhaps they provide a hint at what one significant response to the problem of drug addiction might be. A Christian community formed by the message of brokenness redeemed by grace offers an environment in which those who have been hurt by the world find an alternative approach to suffering and pain. Opioids are a blessing to many people in serious physical pain, but the current epidemic raises the question of whether our efforts to eliminate pain through drugs keep us from the kind of community that can get at our deep spiritual needs. “The Church has to have a response to the wounded,” Rentie says. And the response is beloved community shaped by the cross of Jesus.

Be sure to check out FaithLink, a weekly downloadable discussion guide for classes and small groups.

comments powered by Disqus