Is Using Opiates Ever Justified?

By Author: Steven Johnson
Total Articles: 494
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Over the centuries, we've been looking for a magic bullet to give instant pain relief. One of the earliest discoveries was based on the poppy. Depending on how the plant is processed, a range of different drugs can be produced. But there's always been a problem - the extracts are addictive. Even short-term use can produce destructive consequences. When there were no alternatives, significant numbers of people were hooked, sometimes when only suffering minor symptoms. This led to increasing regulation and control as government grew concerned over the social consequences. The first steps were to make all the opiate drugs prescription only. This has never been a perfect system. Drugs always leak on to the streets when the rewards for illegal distribution are sufficiently high. But with the arrival of more effective alternates, it's been slightly easier to control the level of addiction. Except control is never perfect. The death rates show more Americans die through the abuse of prescription medication than through the use of heroine and cocaine combined.

We're the most heavily medicated group of people on the face of the ...
... planet. It's a sad fact more teens experiment with painkillers than cigarettes. Yet every time a state or the federal government suggests tightening up on the prescription of painkillers, there's an outcry. The libertarians among us believe we all have an absolute right to take whatever drugs we want. There should be no legal limits when the only victims are ourselves. So attempts to discipline doctors for overprescribing the narcotic painkillers often stall. It's at this point the argument gets mixed up with the problems of end-of-life care.

There's a strong view in many states that people should be allowed to die with dignity. This means, say, a cancer patient should be given high doses of painkillers even though this will accelerate death. The pro-lifers object saying this is murder, i.e. not death caused by the cancer, but death caused by the drugs. Yet, if lawmakers limit the use of these more powerful drugs without multiple exceptions, people who suffer chronic severe pain may be left without relief. Sometimes the pain from arthritis demands the use of the most powerful drugs. If the discretion of a doctor has been limited, many may be left in pain.

Patients get caught in the middle between government's legitimate concerns about the level of addiction and the politically active groups of citizens who want no regulations for some purposes and criminalization for others. When people suggest a compromise to limit these drugs to supervised conditions, it denies pain relief to people at home. This is an unfair winners and losers situation. Worse, with tighter regulation and continuing demand, the profits from selling these drugs on the streets rises fast. So everyone has a good case for more or less regulation. Once people find Tramadol is no longer sufficient on its own, they pressure the doctors to prescribe the next strongest drug. The fact this is more addictive is not important. People just want to kill the pain. This highlights the flaw in a system that only sees relief in pills. In other countries, cognitive behavioral therapy more routinely shows people how to cope without drugs or only using Tramadol when the pain flares up.