Over the past few decades, while the War on Drugs has focused on nabbing crack dealers and jailing potheads, millions of men have quietly gotten hooked on deadly drugs originally prescribed to them by their doctors: opioid painkillers. Sadly, the number of prescription opioid–related deaths among men skyrocketed 360 percent between 1999 and 2010, according to the Centers for Disease Control and Prevention.
Although opioids such as Vicodin, OxyContin, Percocet, and morphine knock out pain in the short term, their medicinal benefits drop off significantly after as little as one week on the drugs, says Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing. At the same time, the body quickly becomes dependent, craving more and higher doses to match the effects of that first pill. It's no wonder prescription opioids are so addictive: "These drugs are almost identical to heroin," Kolodny says "They are basically heroin in pill form."
In certain situations, Kolody admits opioids are suitable options for pain relief, such as for managing end-of-life pain, when doctors can keep giving higher doses and not worry about getting patients off of the drugs. "They can also be very beneficial for very short-term use, such as to treat severe, acute pain after a surgery or really bad accident," he says.
But if you're nursing nagging knee pain or a perpetually sore back, forget it. "Opioids are a lousy treatment for most people with chronic pain, because they tend to require super-high – and ever increasing – doses." Kolodny says. "And yet, that's where a bulk of prescribing occurs."
Consequently, that's also usually where addiction rears its ugly head. "The most common way young and middle-age men become hooked on these meds is if they throw their back out while exercising or lifting something heavy," Kolodny says. "Their primary care doctor gives them Vicodin with a few refills, and before they know it, they're taking the drug for months and are stuck on it."
Kolodny blames much of this epidemic squarely on one specific opioid: hydrocodone, the main component of Vicodin, Lortab, and several other combination products. He says that in 2011, doctors penned more prescriptions for hydrocodone than for any other type of drug, including antidepressants and blood pressure meds.
But Kolodny insists that doctors aren't intentionally playing pusherman. Rather, they just don't realize hydrocodone's dangers. He says the main reason they're misinformed is because hydrocodone is wrongly classified under the Controlled Substances Act. While OxyContin, Percocet, and morphine are considered schedule 2 drugs – meaning they have a high potential for abuse and can lead to severe dependence – hydrocodone is schedule 3. This classification includes drugs that carry less abuse potential than schedule 2 drugs and may cause only low-level dependence, so there are fewer restrictions on prescribing them. But Kolodny says hydrocodone should be, without question, considered schedule 2 right along with the other opioids. "Because of the wrong classifications, doctors think it's safer than OxyContin, Percocet, and morphine, which it's not," he explains.
Another big reason hydrocodone is so widely prescribed stems from Big Pharma pushing its products. "Starting about 15 years ago, the drug companies fronted a strong campaign to get doctors to prescribe hydrocodone," Kolodny says. "They convinced doctors that they shouldn't allow their patients to suffer unnecessarily, that opioids were a gift from nature, and that it was silly to worry about addiction, because it's rare. That's just not true. Addiction is common. And now we have a national disaster."
Bottom line: Unless absolutely necessary, don't take opioids, even if you do something painful like you throw out your back. "A back can take weeks to heal, but if you stretch regularly and take Tylenol or Motrin, the pain will eventually go away," says Kolodny.
What about that other increasingly popular pain reliever – the green one? "Let's just say this," says Kolodny. "I'm concerned about highly addictive drugs, so I find it interesting that there's any kind of debate raging about medical marijuana when, meanwhile, the equivalent of heroin pills are perfectly legal."