The dangers of pain pills

Peter Jackson made it his mission to learn more about prescription pain medication after his 18-year-old daughter, Emily, died of respiratory depression in 2006 caused by a single OxyContin pain pill.

Over the years, the Arlington Heights dad says he’s learned eye-opening and disturbing information about narcotic pain relievers like OxyContin: There’s not strong government oversight of them; they’re in just about everyone’s medicine cabinet because of a prescription-friendly health care system; and society today is quick — and conditioned — to pop a pill as a fix for pain.

Jackson also found hundreds of other grieving families like his who have lost loved ones to prescription painkillers.

For years, Jackson has spoken at U.S. Food and Drug Administration public meetings and at presentations around the suburbs for tighter controls on such drugs — a position that sometimes puts him at odds with some doctors and pain patients.

Jackson, 60, who heads the national group Advocates for the Reform of Prescription Opioids, planned to be in Maryland today to join a protest outside the FDA’s offices. The protest coincided with an FDA committee meeting where they planned to discuss whether mounting evidence of misuse, abuse and addiction of opioid painkillers should require more scientific and medical evaluation. However, the meetings (and Jackson’s trip) were postponed Saturday because of the big storm set to hit the East Coast today.

The goal of the protest, Jackson said, was to further pressure the FDA into addressing what he says is overprescription of such drugs. He also wants the FDA to do more to protect the public from their potential dangers, including overdose and addiction. That includes stricter labeling on prescription opioid painkilling medication, more awareness-raising education for doctors and patients, and more clinical studies to show the long-term impact of the high-powered painkillers.

“We’re not trying to take it away from people who need it. We want to make sure the medicine is marketed, prescribed and used in a (scientific) evidence-based way,” Jackson said.

An FDA spokeswoman, in a statement, said the agency is “extremely concerned” and has been “actively engaged in addressing these issues for some time.”

The FDA already has restrictive labels on opioid pain killers, the spokeswoman said, and in July approved a program to provide more training for prescribers, more assessment and auditing of providers, and an updated medication guide and patient counseling document.

There is no question that opioid pain killers — powerful pain pills such as Vicodin, OxyContin, Norco and Percocet — are being prescribed and misused in record numbers. The Centers for Disease Control and Prevention calls it an epidemic, resulting in a rise in overdose deaths, emergency room visits and demand for rehabilitation services.

As of 2010, enough opioid pain relievers were sold to medicate every adult in America with a typical 5 milligram dose every four hours for one month, the CDC reports.

However, the idea of tightening restrictions on these drugs is a controversial subject because those who suffer from chronic pain and don’t want more obstacles or higher costs involved with getting their medicine.

“There are two sides to every debate, and this debate probably has six sides,” said Dr. John Prunskis, medical director of the new Barrington Pain & Spine Institute. He also heads the Illinois Pain Institute in Elgin.

While Prunskis discourages opioid pain pills for long-term use in his practice, and often focuses on getting people off those medications, he said the drugs can provide much-needed short-term relief to people who have severe pain from things like cancer or serious muscle and bone injuries.

Prunskis says a crackdown on the pills could hurt well-intentioned doctors who use good medical judgment when prescribing opioid pain pills. The doctors could end up withholding medication from people who need it for fear of drawing attention from the U.S. Department of Justice for mis- or over-prescribing opioids.

“Some doctors deserve it,” Prunskis said. “But there are also doctors who are doing their best.”

The debate over opioid pain pills is caused by competing interests, says Dr. Gregory Teas, the chief medical officer at Alexian Brothers Behavioral Health Hospital in Hoffman Estates and the medical director of the hospital’s Center for Addiction Medicine.

On one hand, there’s a strong consumer demand for pain pills and a limitless supply from profit-motivated drug companies. On the other hand, there is skyrocketing misuse of opioid pain medicines resulting in death and addiction.

“What has really driven opioid use in America is a desire to reduce pain and suffering. They treat it much more aggressively now, and more prescriptions are being written,” Teas said.

He believes educating doctors is key — for example, teaching them not to prescribe more than just a few days worth of pain pills, so there isn’t so much unused medicine sitting in America’s medicine cabinets. He also sees hope in the development of new high-powered pain medicines that aren’t as addictive and overdose-prone as opioids.

“These drugs are possible. Theoretically, they’re out there,” Teas said.

A growing problem

Jackson believes the floodgates opened after OxyContin was introduced to the market in 1996. Its popularity led to a wave of new opioid pain pills, and Jackson accuses the FDA of putting almost no restrictions on how these drugs could be marketed to doctors and providers. It opened the floodgates for primary-care doctors to prescribe the drugs for “moderate to severe pain,” even though they contain similar chemicals to heroin, Jackson said.

“They have oversold the benefits and undersold the risks,” he said.

Jackson doesn’t necessarily believe doctors are to blame; they’re just acting on bad information.

“The information they’re getting from the drug companies has not been based on clinical evidence. We don’t believe the FDA has followed the law that governs approval of drugs,” Jackson said.

Of course, none of it will bring back Jackson’s daughter, a pretty and popular girl who had just graduated from Rolling Meadows High School and was a few days away from starting classes at Harper College in Palatine. Jackson says she was “the most joyful person you’d ever want to be around” and he was blindsided by her death and struggles to understand how one prescribed pill from a medicine cabinet could have ended her life.

Through his advocacy work, Jackson hopes to prevent other accidental deaths as a result of these medications, which he says most people in the suburbs have probably taken at some point. When Jackson fell off his bike a few years ago and needed two stitches on his hand, he said his doctor gave him a month’s supply of the opioid painkiller Percocet. Not long after that, he had dental surgery and his dentist gave him a month’s supply of another opioid, Norco.

“We throw painkillers at problems because we’ve bought this propaganda from drug companies that ... we should not have to live with pain,” he said. “There is a myth that it’s bad people out there who are abusing medications. It’s a complete myth.”