Reframing the Opioid Epidemic into its Proper Context: With results from survey taken in March 2018

In this essay I will address the imperative nature of relieving pain due to its physiological consequences. I will also reference sources that illustrate comprehensively how to do this. I also recommend measure that can be taken to reduce the diversion (particularly by theft, which is responsible for most prescription drugs that end up on the black market) substantially and effectively without reducing patient access to them. I will also elucidate the differences between dependence and addiction, and explain why opioids are essential for the management of severe (or intractable) pain. The American Society of Interventional Pain Physicians (ASIPP) are by far the most recent, comprehensive, detailed, thorough, and useful guidelines formulated on opioid prescribing in light of the national crisis of overdose deaths. Utilizing the ASIPP guidelines in place of the older, and far less comprehensive CDC guidelines would be advisable, and beneficial to millions suffering from chronic pain, and steps that can be taken to reduce the number of deaths resulting from illicit fentanyl analogues such as carfentanil that are driving these deaths. Taking “high dose” –an arbitrary distinction (Kroenke and Cheville, 2017)–opioids off of the market will only cause suffering and death at worst, and inconvenience and suffering at best without reducing overdose deaths. This is especially true when one considers how the vast majority of “overdose” deaths involved illicit carfentanil and its analogues, not drugs prescribed by doctors, and as such there is no rational reason to remove these lifesaving drugs from the market or restrict access in any other manner as has been proposed by the FDA, and enacted via the CDC’s guidelines for opioid prescribing (2016), which have indisputably resulted in a great deal of pain and suffering (Kline and Lamb, 2017) The gaps and inconsistencies left in the management of pain have been profound; in every state in the U.S. since the implementation of the VA Department of Defense guidelines and the CDC guidelines, patients have been expressing disturbing amounts of suicidal ideation on social media sites such as Twitter, Facebook, and on comment threads of news articles. Their complaints and reasons for expressing such sentiments are always in relation to inadequate pain relief, typically because their doctors forcefully, involuntarily, tapered them, a practice with no research showing benefit, and plenty of research showing profound harms, as well as an abundance of testimonials