Painkillers and Hubris: Paul Offit on Opioid Addiction

cv3-dyxvuaamqglPaul Offit, who normally speaks on the topic of his prime expertise, vaccines, came to CSICon with another life and death medical issue, opioid addiction.

This is not one of those issues, as with the anti-vax movement, where we have people trafficking in conspiracies. It’s something more insidious, more embedded in the culture.

The bulk of the presentation was a history of the use of opium for most of the powerful painkillers you’ve ever heard of,¬†and how the medical establishment going back centuries has relentlessly worked to find ways to administer effective painkillers while avoiding the disaster of addiction. From Diagoras in the 5th century BC, who spoke about the dangers of opium addiction, to the present day where Americans use 80% of the world’s painkillers, more young people die from opioid overdoses than in car accidents, and almost 3 million adults are addicted. The image of this post shows Mrs. Winslow’s Soothing Syrup, a teething remedy that was 3% morphine.

Why tell us all of this? I mean, we all know this happens, even if we don’t know the extent or the long history. For Offit, the issue was hubris. He takes great umbrage with “the medical profession’s undying belief that it can effectively separate pain relief from addition.” Certainly it remains to goal to do so, but Offit believes that the profession is not confronting the reality of the situation. “The culture of the prescription pad” perpetuates the problem without really acknowledging the risks, which are overwhelmingly evident.

Because the problem is so deeply rooted in how we know the medical profession to work, confronting the crisis requires skepticism of a non-obvious kind.