Open your medicine cabinet. Now count how many leftover prescription pain pills you have “hidden” behind the Q-tips, Tums, and deodorant. If you find hydrocodone (Vicodin®); oxycodone (OxyContin®, Percocet®); oxymorphone (Opana®); codeine or fentanyl, you are not alone. Six in ten U.S. households have a backstock of these dangerous, highly addictive pain relievers, the detritus of two decades of physicians’ and dentists’ over-enthusiastic prescriptions, according to Dr. Robert Valuck of the Skaggs School of Pharmacy and Pharmaceutical Sciences at CU Anschutz. Valuck, a Park Hill resident, spoke to parents and community members at McAuliffe International School on October 29 about the dangers of opioids.
Seven Opioid Myths
Valuck discussed the seven myths most people have about prescription pain relievers (see sidebar). As Director of the Colorado Consortium on Prescription Drug Abuse Prevention, his language was deliberate. Opioids are not “painkillers,” for no drugs can eliminate pain (Myth 1). More importantly, these medications are not even terribly effective; 40% of the pain relief people taking opioids report, is a result of the placebo effect. Valuck recommends that those seeking pain relief instead alternate ibuprofen (Advil® or Motrin®) and acetaminophen (Tylenol®) every 3 hours. Whereas opioids reduce the pain people experience by only 33%, rotating these common over-the-counter and non-addictive medications reduces pain by 55%.
Colorado’s Growing Opioid Problem
In Colorado, deaths from opioids are increasingly the result of combining opioids with other medications (e.g., benzodiazepines like Ativan, Halcion, or Klonipin). Over half of the 1,012 drug-associated deaths in Colorado in 2017 were opioid-related.
Parents Share Their Children’s Stories to Create Awareness
One of those deaths was that of Jonathan Winnefeld. Just three days after starting at the University of Denver, Jonathan died from a batch of fentanyl-laced heroin. Jonathan’s father, a retired Navy Admiral and former vice chairman of the Joint Chiefs of Staff (2011-2015), wrote about his son’s path to addiction in The Atlantic: “He began by sneaking a bit of alcohol at night in order to bring himself down from the Adderall a doctor had prescribed him, based on a misdiagnosis of attention deficit disorder. By the eighth grade, he was consuming alcohol in larger quantities and beginning to self-medicate with marijuana. Next came Xanax and, eventually, heroin.” The full story in The Atlantic merits a read, as Jonathan’s life was more than just his addiction; he was, in so many ways, like any number of kids growing up in our community.
Suzi Stolte’s adult daughter Heidi died on May 7, 2011 after combining medications. A vibrant woman who loved animals and cared deeply for people, Heidi became a caseworker so she could help others. Stolte recalls the night of her daughter’s death, before the phone call that upended her life. She was anticipating the next day, which was Mother’s Day. When Heidi’s boyfriend called at 10pm, he had already dialed 911. But in the seven minutes it took Stolte to drive to her daughter’s home, Heidi died. Her prescription medications (Vicodin for pain relief, Valium for anxiety, and Metaxalone, a muscle relaxant) combined with over-the-counter Benadryl, had killed her.
Heidi had been in a car accident about five years earlier that caused ongoing pain, which doctors consistently treated with opioids; she had just received new prescriptions a few days before her death. Stolte recalls expressing concern with her daughter’s continued need for medication, but Heidi dismissed her mother’s words, saying “Mom, you don’t understand.” Stolte acknowledges now that she did not in fact understand. “I didn’t understand the dangers of combining these drugs with alcohol, Adderall, benzodiazepine, and over the counter medications. I didn’t understand why she needed to take more pain relievers than the prescriptions called for.” Stolte shares Heidi’s story in hopes that other families will not experience this devastating loss.
Opioid Education and Treatment Programs
Stolte is the Communications and Marketing Director for the JP Opioid Interaction Awareness Alliance, which works to educate people about the dangers of combining medications. For more information see: http://www.jpopioidalliance.org/
Michael Miller, Communications and Chapters Director for Young People in Recovery, shared his own story of addiction and recovery, and emphasized the need for more evidenced-based recovery programs in Colorado and nationally, especially in rural areas. Young People in Recovery is a national organization that works to “provide the training and networks all individuals, families, and communities need to recover and maximize their full potential.”
Reducing Opioids in Our Homes
The stories and experiences of Jonathan Winnefeld, Heidi Stolte, and Michael Miller underscore the power each of us has to reduce the availability of opioids. Go through those medicine cabinets and collect these dangerous drugs so they don’t fall into the wrong hands. Children’s Hospital, Denver Health in Lowry and Montbello, and numerous Walgreens have permanent collection boxes for disposing of unused medications. For more sites and more information on safe disposal, go to: http://takemedsseriously.org/
Seven Opioid Myths
1) I can get to a pain level of zero if I take enough pills.
A zero-pain level is neither attainable nor desirable. The best pharmacology reduces pain by about 50%; opioids are not that powerful, and only reduce pain by 1/3. After taking a recommended dose, a patient’s pain plateaus; taking more pills doesn’t reduce their pain further but increases side effects.
2) The U.S. is #1 in treating pain.
No. We are, however, #1 in dispensing opioids; the U.S. consumes 80% of the world’s opioids.
3) They must be the best at treating pain since they’re Schedule II drugs.
The DEA’s Schedule II criteria do not refer to a drug’s efficacy; they only speak to its dangers. Per the DEA’s website, these are “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous.”
4) But I had surgery. I need serious drugs.
Opioids are not required after surgery; opioid-sparing protocols exist for most major surgeries. Communicate with your doctor or dentist to request such a protocol.
5) You have to be pretty messed up to get hooked.
People of all ages, races, and walks of life succumb to addiction. Studies document a correlation between the number of pills dispensed and the likelihood of becoming dependent on opioids.
6) It’s ok to combine prescriptions. They’re from my doctors.
Combining drugs can be deadly. 51% of Colorado’s opioid deaths in 2017 were the result of combining common benzodiazepine drugs (Ativan, Halcion, Klonipin) with an opioid. Do not combine opioids with sedatives like Ambien either!
7) I might want to use those outdated medications stashed in my cabinet. What’s the harm?
Fully 87% of people who become hooked on opioids begin with using leftover medications—often from a family member, a neighbor, a friend who may not even notice the missing drugs.
The free and open to the public informational event was sponsored by the Cherry Creek Rotary Club. For more information on future speakers and events in the Innovation Zone speaker series, check updates and/or contact: www.ndiz.org.