Like Pushing Water Up a Hill

This latest attack on the pharmaceutical industry, sadly, is too little, too late. Placing limitations on over-the-counter pain relievers and banning certain narcotic pain medications will prove to be a waste of tax payer dollars. These measures have as much of a chance at success as someone trying to wipe out the lightning bug population by going after the ones that blink.

There has been a great deal of debate in Washington DC regarding the limitation and elimination of a number of over-the-counter pain medications as well as some popular narcotic pain relievers. The FDA suggests that by reducing the strength of over-the-counter meds, it will sharply reduce the number of overdoses that occur each year.

Before we can proceed with this line of thinking, I think it would help to better understand why OTC pain relievers are abused in the first place. The first thing we can rule out is that aspirin, Tylenol and Ibuprofen have a nonexistent risk for abuse. None of these medications, when used alone, create any sort of pleasant euphoric effect no matter the dosage. However, there are many prescription medications that contain NSAIDS and many of the NSAID overdoses treated in hospitals are the result of poisoning from the abuse of these medicine's narcotic components.

A few years ago, I confronted my pharmacist wondering why most narcotic pain medications contain either acetaminophen, aspirin and ibuprofen. He explained there were two reasons. The first reason was that drug manufacturers found that by adding NSAIDS to narcotic pain meds, they were able to reduce the amount of the narcotic without reducing the medicine's effectiveness. The other, and not widely discussed, is that drug companies added NSAIDS in an attempt to limit it's abuse potential. Ask the FDA and these drug companies how this plan has worked out for them. The only thing that changed was the number of NSAID overdoses that were being treated in hospitals around the country.

Before we continue, we need to look at this whole thing as seen and heard by the eyes and ears of someone with an addictive personality. If these measures are approved, it will only exacerbate the problem. Addicts believe that if taking one pill helps, taking two pills will work even better. The same also applies to OTC medications. This is especially the case among drugs that have gone from being just a prescription medicine to one that can be purchased over the counter in a reduced strength. In fact, drug companies encourage this line of thinking by offering these medications at exactly 1/2 the strength of their presumption only counterparts. By marketing these OTC variations at exactly half the prescription strength, this tells consumers that taking two of the OTC drug is equal to 1 dose of the prescription strength version of the same drug. This only serves to reinforce the myth that states the more you take the better it works.

If this legislation is approved, an even bigger mistake would be if in addition to reducing the amount of NSAIDS in pain relieving drugs, they also reduce the strength of the narcotic component. Drug companies will likely approve such a measure because they understand their customers better than the FDA. They know that if such a measure is passed, their customers will be forced to buy more of their product in order to maintain the same dosage.

If we support this measure, it is going to become even harder for patients with pain to receive the medications they need to obtain any kind of quality of life. I think the only change that will take place is drug companies are going to see a sharp increase in annual sales. Hardest hit of all are the tens of thousands of Americans living with horrible pain every day. This pain, the result of botched surgeries has resulted in a cocktail of powerful narcotics that would likely kill anyone not used to the dosage. Although deadly to most, this miracle of modern medicine has proven to be the only way this loved one can do things like walk, climb stairs, and do most other daily tasks that are often taken for granted. Maintaining care for our loved one has not come without a price. Insurance companies, doctors and even the U.S. Government has made several attempts to reduce or even eliminate the dispensing of these controversial medicines. We fear that if this pharmaceutical witch hunt continues, what life for our loved one remains, will be drastically cut short.

I think we need to remind ourselves that addicts will take extraordinary measures to maintain their habit and likewise, people living with chronic pain will do almost anything to obtain relief from it. The last ten years have seen the largest increase in the cultivation and manufacture of high grade opium; the organic narcotic ingredient in such things as heroin, Oxycontin and Vicodin, in decades prior. In fact, the U.S. Ambassador to Afghanistan reports that an estimated 500,000 acres of drug-producing opium poppies were grown last season and that Afghanistan now accounts for more than 92% of the world's opium. As a result of this alarming growth, the price of heroin on the street has dropped sharply. Right now, the price of 1 Vicodin ES tablet (which contains 7.5 milligrams of hydrocodone) averages about $6.00, or about 80 cents per milligram. On the other hand, heroin; three times more powerful than morphine, sells on the street for about 18 cents per milligram. If addicts and persons living in terrible pain can no longer obtain federally regulated prescription medication, where do you think they will turn to improve the supply line?

The more I thought about this subject, the more I began to suspect that drug companies true motivation had nothing to do with public safety. Imagine you are a top executive for a company that manufactures and distributes narcotic pain medication. Let's say your main competitor is able to sell their products at a price you know can never meet let alone beat. What would your strategy be? I believe these drug manufacturers realize the end is near and will do anything it takes to earn as much as they can until their market disappears. And so, they devise a plan that will allow them to lower the amount of the ingredients but will still charge consumers the same price as the full strength drugs available today.

All speculating aside, what can be done to fix this? I think we need to focus more on education programs pertaining to fitness, nutrition and counseling.I think doctors should also improve their ability to spot potential abuse among their patients. These suggestions will not be the magic bullet needed to fix this problem. But they would be a good start. I am all for a drug program that reduce the number of drug related illness and death, but at what expense? Sadly, as we have seen over and over in our culture, it's always the honest, law-abiding citizens that are forced to pay for the poor choices made by criminals.