LET’S TALK ABOUT…MORE ON THE OPIOID EPIDEMIC !!! Several of my readers have been contacting me about fears of how the opioid epidemic will be effecting the pain medications they are presently taking for their individual pain management.

One man passionately exclaimed to me “My back pain is real!” He had a morphine pump permanently implanted to manage his chronic pain. He had two concerns about everything he is reading about “cracking down on prescription drug providers”.

The first concern is that the doctors will remove his pump in lieu of “some alternative approach”. “Before I had this pump I was taking all kind of narcotics—both legal and illegal. I have had this pump for three years—three years of well managed pain and consciousness.” He pointed out the increase in family activities, and, generally more appreciation of life.

The second concern he had was that people that haven’t experienced the level of pain he has “…won’t be able to understand why I need ongoing treatment. They will just point to me as an addict or junky.”


Opioids are also called narcotics. Common types of opioids include hydrocodone (Vicodin), oxycodone (OxyContin), morphine, and methadone. Fentanyl, typically used to treat advanced cancer, is 50 to 100 times more potent than morphine. Heroin is an illegal highly addictive opioid.

The Center for Disease Control (CDC) reports that the “most recent cases of fentanyl-related overdoses ” connected with the illegal heroin market. “It is often mixed with heroin and/or cocaine as a combination product-with or without the user’s knowledge—to increase its euphoric effects.”

It is not uncommon to find an heroin/fentanyl combination overdose victim deceased with a needle still in their arm.

At one time there was a clear separation of “us” and “them”: “us” the responsible opioid users monitored by an ethical medical physician. “Them” being the illegal drug users that steal other’s prescribed drugs, obtain their fixes from illegal/unethical prescribers, or buy/steal their drugs from the street culture that originates with illegal domestic and foreign cartels.

Unfortunately, over a decade the “us” and “them” have become blurry.


The CDC “Heroin use has increased sharply across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes.”

A highly respected well-dressed professional woman recently came to me because her doctors took her off “all pain medications”. She had almost died from an “accidental” overdose. She was still detoxing from that experience. It was obvious that she was drug seeking.

Just when I thought she was making progress, she decided she needed to have some “dental work” done that she had been putting off. The dentist prescribed Vicodan for pain. Her “unintentional” cycle began all over.

The difference between “us” and “them”: “us” puts the accountability in the medical practice prescribing; “them” assumes the accountability of finding what they need haphazardly on the illegal market.

Now that the Opioid Epidemic has changed the face of “addiction”, pharmaceutical prescribers are going to have to pay closer attention to who are “us” and who are “them”.

Glad we talked about this. Of course, it is just my opinion.



Springfield Times

“Ask MAx” is published weekly in the Springfield Times, Springfield, OR. You can subscribe to the Springfield Times at


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