Psychiatrist: US is paying now for using opioids for years to manage pain

The US “is paying” now with a serious opioid crisis for prescribing such medications for many years to manage pain in hospitals, a situation that has made fentanyl the main drug linked to overdose deaths.

In an interview with EFE, the Spanish psychiatrist and director of the Physician Affiliate Group of New York (PAGNY), Luis Rojas-Marcos, said that during the 1980s a “general movement in favor of treating pain” - a “universal complaint” among patients - developed in US hospitals.

This spurred significant investment by the pharmaceutical industry in developing medications derived from opium for palliative care.

In fact, the psychiatry professor with the University of New York and former director of the city’s hospital system said that the need to alleviate patients’ pain is tied to the current increase in suicides and overdose deaths in the US which, according to the latest figures from the Centers for Disease Control and Prevention , resulted in a drop in the average lifespan for Americans in 2017 to 78.6 years, one-tenth of a year lower than the year before.

According to the CDC, suicides were ranked 10th as the cause of death in the US last year at 14 per 100,000 deaths. In all, the CDC calculated that 70,237 overdose deaths occurred in this country in 2017, or 21.7 per 100,000 deaths.

Rojas-Marcos said that “when the coroner sees the body of a person who has (taken) fentanyl - a synthetic opiate derivative similar to morphine - heroin or an excess of medication, those deaths are usually classified as suicides.”

“That has been what has increased - more than suicide in and of itself,” said Rojas-Marcos, who has worked as a psychiatrist in New York for 50 years.

“I don’t think that it would have been the intention to create addicts, but the skill to notice the situation didn’t exist,” he said.

The medications were so addictive that they created dependence among those who took them, although the pharmaceutical industry paid for “contaminated studies” to assure people that the opposite was the case.

The doctor referred back to 2007, when the manufacturer of OxyContin pleaded guilty to deceiving regulators, doctors and patients about the addictive risk of that opiate.

Rojas-Marcos also noted drug companies’ pervasive television ads and stating that the US is one of the few countries where all types of medications may be publicly advertised.

“If you turn on the TV ... all you see are ads for medications. ... Take this for arthritis, pain, impotence ... and finally they very quickly tell you of the secondary effects. That’s done to lead the customer astray so they don’t know,” he said.

“Addiction and abuse of these medicines began to increase and when you leave the hospital but need a prescription to buy them, people start with fentanyl and other drugs from Mexico or China,” he said.

The foreign origin of these opiates, said Rojas-Marcos, creates the risk of consuming too great a quantity of the drugs, resulting all too many times in a fatal overdose.

The PAGNY official also pointed to other social and economic factors explaining the increase in suicides, including our very individualistic society and the high cost of healthcare and psychological treatment.