The Consumer Reports cover story: “America’s Scary Pain Pill Habit”

consumercoverThose of you who read my column regularly know that I’m a big proponent of pain medicine, and I regularly discuss how it is getting more and more difficult to obtain these medications.  This is due to the demonization of opioids in the media, as well as prescription drugs being the target du jour for America’s ridiculous “War on Drugs.”  Those of us who are in chronic pain have a growing crisis on our hands, and vary rarely do we receive any help from the major news outlets.  Fortunately, though, Consumer Reports has just published an article about pain medication, and even though I haven’t read it yet, I’m sure that it responsibly weighs the pros and cons of opioids and helps to dispel some of the myths and half-truths that are whipping the public up into a frenzy of anti-opioid hate.

Hmmm?  What’s that you say?  I should read the Consumer Reports article?  They did what?!

For those of you who haven’t gotten the chance to read the Consumer Reports pain medicine article, I suggest you do so as soon as possible.  At a time when we are fighting a losing public relations battle against the entire country to keep our pain medicine in our cabinet, they have published an article with the worst kind of sensationalist reporting and narcotic McCarthyism, filled with buzz words and dubious facts that I can only assume is meant to rile up a public and generate publicity for an organization that has seen fading returns in recent years.

National Pain Report takes apart the Consumer Report article, piece by piece.  Some of the issues addressed include the article stating in a misleading way that as the number of opioid sales increased from 1999 to 2011, so did the number of deaths reported. It seems to me that as you increase the amount of a certain medication in the world, the number of deaths from that medication will also increase.  I wonder if Consumer Reports expected the number of deaths to decrease as the amount of opioids increased?  It frightens me to think that Consumer Reports, an organization that bases a large portion of its research on numbers, doesn’t seem to grasp the very basic concept that more means more.

Another significant part of the Consumer Reports article covers the painkillers acetaminophen, ibuprofen, and naproxen.  Wait, what?  As of now, none of those drugs are opioids, nor do they contain narcotics.  For some reason, though, the article spends at least six paragraphs discussing the dangers of people taking too much of these over the counter drugs.  Now, when I say “take too much,” I mean more than the maximum safe daily dosage listed on the bottle.  So, if I’ve deciphered their puzzle of words correctly, Consumer Reports is saying that it’s dangerous for consumers to take more than the maximum dose listed on the bottle.  So they take up one-third of an article about the dangers of opioids discussing these non-opioids, and then towards the end of this section, casually link it to the subject of the overall article by quoting a doctor saying “All of this doesn’t mean that everyone should avoid opioids and acetaminophen altogether.”  Wait, what?  Weren’t we just talking about acetaminophen?  It’s a quagmire of words that makes even the most erudite head spin.

Consumer Reports also goes on to say that 60% of all patients who overdose get their scripts from one doctor, and don’t go “doctor shopping,” or seeing multiple doctors for multiple scripts.  I am assuming they are referring to study by the CDC, and while their numbers are technically correct, I believe they are so intentionally misleading that the author should be stripped of his ability to write articles.  Let me break it down for you.

Now, follow me here, because the math gets a little tricky.  What the study actually says is that 90% of patients in the country get their opioids scripts from one doctor, and only 10% go doctor shopping.  Of those 90% who see one doctor, 80% of take a low dose of opioids, and 10% take a high dose of opioids.  Those majority who take a low dose of opioids account for just 20% of overdoses and the 10% of patients who take a high dose of opioids account for 40%, twice as much, of the total overdoses.  So as I understand it, what the study is really saying is that the great majority of patients in the country actually take a low dose of opioids and this great majority of patients only accounts for one-fifth of all overdoses.  It also says that the patients who take more pills are responsible for many more overdoses.  So, once again, Consumer Reports seems to have an issue with the fact that more results in more.  I’m starting to realize now why all those CD players I bought on their say broke after a month.

Next, Consumer Reports claims that the belief among the medical community that opioids are not addictive when properly administered to treat pain is a myth, saying that somewhere between 5 and 25 percent of people who use pain pills long term get addicted.  Well, I’d like to read that study, because one-fourth of us turning into zombie-pill heads would mean that my trips to the pharmacy should look a lot more like an episode of the Walking Dead.  “Mmmmmm.  Brainsssssssare good but I want more narcotics…”

Finally, Consumer Reports claims that another misconception is that “extended-release versions are safer.”  I have never heard that claim in my life, to be honest, and most doctors will tell you that extended release and instant release are used for completely different things.  The article goes on to say that “some doctors prescribe them [the extended release versions] for convenience.”  Well, I have never, in my life, met a doctor who compromised his ethics to prescribe a significantly more powerful medicine because the patient whined a bit about having to take an extra dosage or two.  In fact, the only doctors I know who would do that are the ones who you can also pay to take off their clothes.

The biggest irony of the whole Consumer Reports article is that it was sponsored by and written on information provided by a group called the Prescriber Education Grant Program, which is funded by a multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).  This stems from a case brought against Pfizer by people who claimed they were misled into believing that the drug was effective for pain relief.  Now, I’m not claiming it was or wasn’t effective, but does anyone else besides me realize just how utterly insane this is?  This article about the evils of prescription pain medicine was sponsored by a group that brought a court case against Pfizer because they believe they were wronged by a prescription painkiller.  Holy conflict of interests Batman!

This article is beyond the pale and the worst kind of sensationalism. Consumer Reports obviously needs the traffic, and as they say, there’s no such thing as bad publicity.  I’m not thrilled that I’m helping to increase their notoriety, but I need to call them out on this one.  The way things are going, pain pills can’t take many more hits before they go down for good, and people like me who need them to live each day will suffer needless, intractable pain.

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