Obamacare

Reason.tv: Will The Feds Ban Your Pain Meds?

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What if you were injured and developed severe pain that wouldn't go away? Would your government let you take the kind of pain medication you need? If federal officials follow the recommendation of a Food and Drug Administration panel, many of the most effective prescription painkillers—including Vicodin, Percocet, and countless generics—would be banned.

Scott Gardner says that kind of a move would be "intensely cruel."

"I took Vicodin for three years," says Gardner. "I needed it. It got me through a very tough period of my life." The tough period began after a cycling accident shattered the left side of his body. After eight surgeries and countless hours of physical therapy, Gardner's once active life is now filled with limitations. He suffers from chronic pain that prevents him from sleeping more than a few hours at a time, and yet his pain today is nothing compared to the agonizing days and months following his accident.

"When there's nothing but pain, there's no reason to live," says Gardner. "There were times where the only way I could stay sane and civil was because I could take painkillers."

The fear of addiction and abuse already makes many suspicious of pain medication. Media reports about celebrities like Rush Limbaugh or Matthew Perry suggest that it's common for people to become addicted to medications they once took for legitimate medical conditions. And countless public service announcements remind us of the dangers of prescription drug abuse.

Now the old fear of prescription drug abuse takes a new twist. The FDA panel is targeting drugs like Vicodin and Percocet because they contain acetaminophen, a popular painkiller also found in many over-the-counter drugs. Panel members warn that some Americans ingest too much acetaminophen, and overdoses can lead to liver damage, even death.

But maybe the FDA panel isn't putting this threat into context. After all, mundane threats like falling down stairs claim more lives than acetaminophen overdoses. And it turns out the more common fear—that patients will become addicted to prescription drugs—is also overblown. In fact, the barrage of warnings we hear about prescription drugs obscures an important point—people saddled with severe chronic pain need these painkillers.

Says Gardner, "I  think people who haven't dealt with pain don't really know what it's like."

"Don't Get Hurt" is written and produced by Ted Balaker, who also hosts. The director of photography is Alex Manning, the field producer is Paul Detrick and the animation in the piece is from Hawk Jensen.

Approximately five minutes.

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Related video: When Cops Play Doctor: How the Drug War Punishes Pain Patients.

For Reason.com's coverage of "opiophobia," or overblown fears by the government about prescription painkillers, go here.

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  1. But if the FDA ever admits there are worse fates than being a drug addict (like living in constant pain), then people will start to wonder why the hell the things are illegal in the first place. And we cannot have that. Better to let people live in abject misery than admit that maybe possible sometimes drug use can be the best of a set of bad options.

  2. Chronic waking keeps me from sleeping for more than a few hours at a time.

  3. Don’t Vicodin and Percocet contain acetaminophen precisely because it makes them poisonous in large doses, and they do so at the behest of the FDA itself?

    1. +1
      yep you got it. thats why you should order from australlia or NZ. you can get codeine with ibuprofen OTC. and some countries you can get stronger opiates as well. you just need to think outside the US FDA box

      1. Except that codeine is shit, Paul. It’s barely effective in any sense; it’s barely better than propoxyphene, which is itself useless.

        1. Codeine is waaaaaaay better than propoxyphene which is as totally useless as tramadol only much more toxic.

          1. I can get quite high on tramadol, but it is not the normal opiate high and it’s not very good for pain relief. Plus it has shitty side effects.

            I can take a hell of a lot of codeine and barely get a high or much pain relief. I wish it were different, believe me.

            1. How do you get high on tramadol? I can’t feel a damn thing(150mg max dose).
              Codeine is an excellent pain reliever and it gets me high. Try the “uncut” kind with no tylenol or aspirin if you can get it.

              1. Got to agree with SIV, Tramadol sucks. Completely useless for pain relief.

                1. Yep. I had an old-school doctor who prescribed Vicodin for my shoulder/neck pain from a sports injury. Worked great. Then he was replaced by a young doctor who insisted I take Tramadol instead. Tramadol does not work.

                  What really pisses me off about it is that Tramadol does make me feel ‘high’, in that I feel dizzy sometimes when I take it. But it doesn’t relieve the pain, which is why I took the Vicodin.

                  So to stop me potentially abusing a controlled substance that worked, the doctor gave me a controlled substance that doesn’t work. And now when I have pain I just have to suffer through it. Thanks, Big Brother!

                  1. acetaminophen is added because it makes the opioid more effective for a longer period of time. it’s a synergistic effect. it is most certainly not added to make it poisonous.

    2. How about manufacturers just remove the acetaminophen? Personally it doesn’t work for me at all. I like Ibuprofen- it’s a wonder for headaches.

    3. Yes, they would rather see you poison yourself to death than risk you enjoying your narcotic buzz too much. Nevermind that pain sufferers get little or no buzz from pain killers. Let’s be honest – the real reason for the drug war and the war on pain killers is a Carrie Nation like puritanicalism (well, now the drug war is a powerful, for profit industry, but that’s another story.) I used narcotic pain killers for years off and on. I quit just because I was sick of using them and they didn’t ultimately help very much. The effects of quiting were minimal to nonexistant. Had a little trouble sleeping for two nights. The hysteria over drug abuse is just that – hysteria. American’s can’t be happy unless they can be hysterical about something.

      1. We’ve got terrorism to be hysterical about now, can’t we move on from drug hysteria already?

  4. They won’t ban it. They will just limit prescriptions to one pill at a time, so you have to go to the doctor every day to get your fix. That way the doctor can monitor you and make sure you don’t use them inappropriately. Because that’s how doctors would prefer to spend their time anyway.

  5. Is this a little misleading?

    They are not going after pain pills, they are looking at ending the combo pain pills with acetaminophen and Ibuprofen. No?

    If I need vicodin, just give me straight vicodin. I’ll pass on the cut.

    1. Exactly right. The narcotic will end up separated from the acetaminophen. People will still get their pain-fix. This is being blown out of proportion.

    2. Exactly right. They’ll end up separating the narcotic from the acetaminophen.

      1. Narcotic- nasty filler=schedule II

    3. You mean straight hydrocodone. “Vicodin” is a particular brand blend of hydrocodone and Tylenol.

      1. Ah. Yes.

  6. In better news, check this out
    Unionized Rhode Island Teachers Refuse To Work 25 Minutes More Per Day, So Town Fires All Of Them

    http://www.businessinsider.com…..hem-2010-2

    Wow does that make me smile.

    1. Would have been better if they were flogged while being run out of town after being tarred and feathered. But I guess getting fired will have to do.

    2. It’s nice to hear some good news for a change. Good job, John.

    3. Teachers are protected by unions to prevent this exact sort on nonsense from happening. They will be hired back, the superintendant can’t unilateraly violate a contract. Teachers are harder worling than you think they work hours and hours at night grading and make much less than private employees that make vastly more. That is why they get slightly better benefits and a little mor vactation time that most of is used to take more courses that is required for them to take. I know because I am a teacher.

      1. Cindy, I’ve seen Teachers, so I understand. So, do you look like Nick Nolte?

      2. There seems to be a lot of hate for teachers around here. I am not sure why. The unions, like all public sector unions, deserve much derision, but in my experience most public school teachers are hardworking people who do care about what they do. There are plenty of duds too, but that is true of any profession.

        1. Most workers I know are hard working people. Teachers aren’t especially more hard working than any other set of workers.

          The reason teachers are generally denigrated and disrepected is because they aren’t much more educated than the general populace, yet have a snearing disregard for parents and accountability to society at large, then hide behind their union reps and administration. Also, many make the classroom a political indoctrination area. I remember being preached at quite a bit by about a third (their should have been none) of my teachers as to how Reagan and Bush Sr. were ruining the country, how blacks can’t be considered racist, how I should be ashamed of my european heritage, how public employees are proud public servants, while business men are greedy pigs, etc.

          On top of that, teachers only work for 9 months out of the year, so the $72k salary is equivalent to $96k. Yet they fail at a shockingly high rate to educate young people in the very basics. A shockingly large fraction of high school students don’t understand that basics of reading and phonics, nor the basics of arithmetic considering the arithmetic of fractions almost completely out of their grasp, nor know the basics of American, much less Western, history and government.

          Any private sector business that ran itself the way public schools run themselves would fail.

          1. Ken, how many teachers do you know well? Where the fuck do teachers make $72k? Where I live the starting pay is somewhere around $30k. Everywhere that I have been, teaching is a low paying job. SO of course the most qualified people are not all becoming teachers.

            Teachers’ unions suck and public school systems in many ways suck, but that is hardly the teachers’ fault. Public schools should probably not exist for these and many other reasons, but people going to public schools still learn to read and write and do basic math (I assume they still do, I could be wrong, I suppose). There is some value to this and there are many excellent public school teachers.

            1. Nassau county, Long Island?

          2. The nine months is because of the summer vacation that is needed by the teachers because of the stress of the job compared to other careers they need it to relax. Much of the summer is because to take courses that is required.

          3. …don’t understand that basics of reading and phonics

            Phonetics is old school, we teach whole language.

            nor the basics of arithmetic…

            Not a part of the new math.

            nor know the basics of American, much less Western, history and government.

            Not true even though now we teach the multiculturalism that it includes American.

      3. Please tell me that you don’t teach spelling, grammar, or composition.

        1. +1

      4. Teachers are overpaid lackeys of the state. They score lower on standardized tests (as a group) than auto paint and body vo-tech grads.

        1. Leave the auto paint and vo tech grads alone. Unlike teachers, they actually perform a useful service and perform it well.

          1. You really think that there is no value to schooling?

            1. I didn’t say it wasn’t a “valuable service”. I said it wasn’t “performed well” by most teachers.

              1. OK. I missed the “and perform it well” bit.

      5. Teachers are harder worling than you think they work hours and hours at night grading and make much less than private employees that make vastly more. That is why they get slightly better benefits and a little mor vactation time that most of is used to take more courses that is required for them to take. I know because I am a teacher.

        Oh, my. I’m just going to sit quietly and savor these sentences. Oh, so good…

        1. I knew there was a reason that i couldnt understand what cindy was saying. I just thought i was having a retard moment.

      6. Cindy read the article. The teachers in that community make between $70 and $78K a year. The average salary in the community is $22K. Over three times the average salary for what? A bunch of C students who skipped the hard classes and took slide projector and oppression studies (oh I mean Education) courses instead.

        Teachers are totally overpaid. The only ones more overpaid are administrators. Yeah, teaching is an impossible task left to the professionals. That is why home schooled kids generally kick public schooled kids ass on standardized tests.

        Sorry, but the days of anyone buying into the “poor underpaid teacher” line of bullshit are coming to an end.

        1. I think teachers are not the problem. How many of them DONT WANT to be represented by unions? Do you think every teacher at that high school approved of what the unions were doing? Probably not. But they have no individual say.

          1. They can just go back to work and work the extra 20 minutes and tell the union to go fuck itself.

            1. Wow! I have a way overactive imagination and the visula on that one almost made me hurl! (Union hacks pleasuring themselves. )

        2. “”Teachers are totally overpaid.””

          Assuming that’s true, it got that way via a collective bargining process. Unions don’t get to decide on their own. Blame can be spread around.

          I doubt any teacher, much less anyone else, really thinks they are over paid. If they do, are they asking for a pay cut?

          “””Sorry, but the days of anyone buying into the “poor underpaid teacher” line of bullshit are coming to an end.””‘

          Depends on where you are. Not all teachers make that much, some are underpaid.

          So who should decide how much a teacher gets paid? Do you support government imposed pay restrictions?

          1. Since they you know work for the government and get their pay from the government, I would say that by definition any cut in teacher pay would count as “government imposed pay restrictions”.

            I would also note teachers at private schools make less money than those at public schools. Yet, private schools are generally better than public ones.

        3. That is why home schooled kids generally kick public schooled kids ass on standardized tests.

          I find that a little hard to beleive because they don’t have the proper certifications.

          1. You are kidding right?

            1. No, you realy expect them to learn good when not taught by a properly certified teacher.

              1. to learn good

                Learn well, Cindy. Learn well.

                But, on the other hand, you’ve convinced me that you’re actually a public school teacher.

                1. I see a career in tea party sign making in someone’s future.

              2. I am beginning to think that Cindy is a joke.

                1. Yes, she is a trol having funn.

            2. I’m fairly sure Cindy is a troll.

      7. My father-in-law teaches along with both sister-in-laws. They don’t work that hard. They all have their masters plus thirty which is a racket and so far from anything even remotely looking like a regular masters degree it isn’t even funny. The father-in-law was bought out on his retirement for a decent sum and now works for a parochial school, both sisters in law clear 50K in the midwest with less than 10 years exp. They are paid proportionally for the amount of work they do and their education.

  7. I really wish the FDA would stop saving me. I’m smart enough to figure out or find out what is bad for me and then weigh the risk versus the reward. Especially given the amount of information disseminated to the masses in today’s society.

  8. “After all, mundane threats like falling down stairs claim more lives than acetaminophen overdoses”

    “Hey, accidents happen and it would be unfortunate if a certain government were to find itself at the bottom of a certain set of stairs because of an accident.”

    FIFY

    1. I wasn’t aware of this danger. Maybe the government should only issue building permits for one story ranch houses?

  9. They are not going after pain pills, they are looking at ending the combo pain pills with acetaminophen and Ibuprofen. No?

    No. That would be rational. They’re going to ban the combo pills without replacing them with non-combo pills, even though the health risk for which they’re being banned was created by the FDA itself. If they start allowing non-combo prescriptions they’d be admitting their war on pain meds was a bad idea.

    1. I don’t think they will allow non-combo prescriptions because it is possible to get high on them without dying from the acetominophen. The reason for the combo is to make it so you cant take too much.

      1. “””The reason for the combo is to make it so you cant take too much.”””

        Sounds like BS, you have something to support that claim?

    2. Bob, Are you just speculating, or do you have any actual support for what you are saying?

      1. Informed speculation. Combo pills were an FDA mandate. The only purpose for them was to prevent using “too much” pain medication under pain of death. Do you see any evidence in this story that the FDA has changed its position on this matter? No? Then it follows that unadulterated pain meds won’t be allowed if there is no pharmacological deterrent to their use.

    3. Um… the non-combo pills are already available, you know. Percocet – tylenol = oxycodone. Vicodin – tylenol = hydrocodone. You can get prescriptions for both – it’s just that they’re schedule II rather than schedule III. The FDA didn’t require them to add the tylenol in order to sell them, they just made them add it if they wanted them classified as schedule III narcotics.

  10. Maybe the prices will drop as the pills move from the regulated normal market to the gray and black markets. There’s always an upside. Pharmaceutical cost problem solved.
    Plus think of the positive impact on the new hiring of SWAT teams to enforce drug policy on old ladies in pain. It’s a win/win. Pills at market costs and jobs saved or created to bash down old ladies doors and shoot their poodles.

  11. I agree with Spartacus. I think they will make it so the pharmacy allocates the daily dosage.

  12. Vicodin is fine. Hell, Dr. House pops them like Tic Tacs.

  13. Fact – Prescription opioids* are often sold by poor brown people on the black market to other people who just want to get stoned.

    Fact – Many of the pantie wetting, drug warring, social engineer types perceive this to be a far more serious problem than people with intractable pain.

    It would take pharmaceutical companies about one week to start producing acetominaphen free opioids.

    * I’ve yet to see convincing evidence that the patented opioids are any improvemnt over refined opium (heroin and morphine).

    1. It would take pharmaceutical companies about one week to start producing acetominaphen free opioids.

      I agree, If I need codeine and tylenol, I can take each separately at the same time. All the combo does is maybe discourage some misuse, while causing much more harm to those who do misuse them, and harming long term pain patients. Opiates by them self are not physiologically harmful.

      I’ve yet to see convincing evidence that the patented opioids are any improvemnt over refined opium (heroin and morphine).

      Do some of them produce less of a histamine reaction? That is all I can think of. Some of the synthetics, ex Demerol are worse, and others ex Fentanyl are probably more dangerous.

    2. acetic anhydride works wonders on raw opium

      1. Does it turn it into dihydromorphine?

        1. Or rather diacetylmorphine (heroin), my mistake dihydromorphine is dilaudid.

    3. Just a point of correction. Heroin is a patented opioid. Heroin was Bayer Pharma’s brand name for diacetylmorphine. It was morphine designed to get past the blood brain barrier at a faster rate.

      I agree that, used correctly, Heroin has been shown to be very effective for the relief of severe pain. I am not certain, but I think that it is still widely used in that way in many of the poorer places around the world.

  14. The FDA is one of the most anti consumer and anti average-american parts of our government. It’s not bad enough they are down to approving 25 new drugs per year.

    I am really tired of people who think the average person is too stupid to make their own decisions. If they were truly motivated by compassion, as they claim, they would not put doctors in jail for giving us pain meds. I don’t know what motivates them, tyranny just pisses me off more and more as I become a cranky old coot. Wow i’m not even 40.

  15. Television helps ease pain, I’m going to tell the goverment and see if I can get televisions, internet broadcating of television, and other such things banned from the USA.

  16. as a chronic pain patient and pharmacologist I would like to thank reason for keeping people informed on this important issue. its bullshit that the feds want to ban this medicine which is very useful for many people. kind of funny that tylenol is getting a lot of shit after over 100 years of use when just a few years ago it was discovered tylenol works primarily on the bodys endogenous cannabinoid system.
    I think if this bs does happen instead of seeing opioid-only prescriptions they will just go to prescribing ibuprofen and aspirin with opioid combinations, which carries the same “problems” they are complaining about now. so instead of percocet and vicodin being the main prescriptions it will be percodan and vicoprofen. its bullshit this should be decided by individuals and doctors, not the government. the FDA is doing more to hurt the sick than anything it does to help them. have you ever been prescribed tylenol with codeine, darvocet, ultracet, percocet, vicodin, dihydrocodeine with tylenol. these meds are generally harmless if taken in responsible doses, in fact many are OTC throughout the world. even codeine with tylenol is still OTC in some US states. fuck the government.

    1. also the hysterics are trying to get them to ban propoxyphene and dextropropoxyphene all together, with or without tylenol, which is insane.

      1. If drugs were legal no one would ever use propoxyphene.

        1. that isn’t true, I know several people who actually liked getting their OTC propoxyphene when they were in Mexico.

  17. So what about addiction. If people want to medicate perpetually that’s their right, and if it helps them function better, it’s probably a good idea too. Who is the government to decide which medicine is best for each and every individual.

    1. If people want to medicate perpetually that’s their right, and if it helps them function better, it’s probably a good idea too.

      Which seems to be OK when it’s an anti-depressant from Pfizer. Just watch out for possible suicidal thoughts. It’s also OK for an asthma controller medication that “may cause asthma related death”. etc etc

      Seems the problem with using drugs only arises when someone, somewhere, might be feeling better as a result.

      NEWSFLASH: Antidepressants Make Users Happy. ONDCP Says Upto 25% of Americans are Addicted. Won’t someone think of the children?!?!?!? Tonight at Eleven.

      (And let’s not get started on the droves of amphetamine addicts attending our nations schools and colleges.)

  18. For what do we need the FDA?

  19. Although as a physician I believe the dangers of acetaminophen overdose to be overhyped, the dangers of opiod addiction aren’t. We’re acting like the main danger here is the Tylenol…it isn’t. Hydrocodone, which is the opioid in Vicodin, Lortab, and various other formulations of narcotic combination painkiller, is the leading cause of prescription related death in every state from which I’ve seen statistics. Having worked in an ER for years, I have seen any number of “patients” coming through with vague pain complaints, which mysteriously resolved when I confronted them with the results of a statewide log of prescription narcotic meds filled. The numbers were sometimes in the thousands of pills in a single month.

    While I realize that there are many people who suffer from chronic pain, Americans consume far, far more narcotic pain meds than other societies with little if any improvement in quality of life. Indeed, narcotic pain meds kill people. If you doubt the numbers, I’ve seen it happen. They depress the respiratory drive. They are dangerous, particularly when not dosed properly. And there are too many physicians that write them with their patient’s returning visits, thus their own self interest, in mind rather than the patient’s health.

    Now the current war on drugs climate and resulting hysteria is ridiculous, I’ll grant you, and I won’t dispute those arguments. But these are not harmless medications that just get people out of pain. Just wanted to make sure everyone remembers that.

  20. I work with hospice alot and pain management is a huge issue. Some idiot in my state wants to regulate hospice nurses because they change pain medication orders without notifying the doctor. Horrors! I’m soooo worried about an 93 year old cancer patient becoming addicted. WTF!?!

    1. When the 93 year old geezers get addicted, they’ll start mugging 106 year olds to get money for their fix.

      You know it’s true.

  21. This is the same way i feel about all these people talking about the abuse of pain killers if some of these people had to live every day with severe pain like i do even with pain medication they wouldn’t be saying the things they say and i agree all these big movie stars that take this med just for the purpose of getting high leaves us the ones that really take this medication for the pain that we are in containly gives us all a bad rep. for taking the medication for our pain even the doctors don’t like helping people like me due to the people who abuse these types of drugs .

    a doctor was killed where i live for asking a man that was hooked on these drugs for a urine test he went home got a gun and came back and killed the doctor right in his office

    people in constant pain is going to have a very hard time getting their medication due to people like this i don’t think that cops or the goverment should be in our business when it comes to what medications that we take they are in.

    1. Exactly right it is BS that us in severe pain get treated like we are drug addicts when we just need these meds to take away the pain

  22. The pain management madness is only going to get worse. Forget the single payer legislation, the government already controls best practices for a huge portion of the health care market. The VA already requires vets to submit to random drug testing as a condition of their pain management contract. You can bet the practice will creep over into Medicaid and Medicare.

  23. Since Percocet is simply oxycodone with acetaminophen and Vicodin hydrocodone with acetaminophen. Both oxycodone and hydrocodone are available in regular tablets. You just take the pure tablet and chase it with a Tylenol. No big deal.

    My daughter uses 2-3 30 mg oxycodone a day (+100 mg of methadone) to try to control her pain. In the past 6 years she’s been detoxed twice under a doctor’s care with no “addiction” problems.

  24. yeah because taking MORE pills is really a good idea for people that have trouble keeping them down…

  25. Yet another example of federal bureaucrats getting off on telling you what you can and can’t due based primarily on a perceived risk and not actual data.

  26. I am allergic to asprin and ibuprophen. When I take it, my lips swell for several hours. So when I have a toothache or if I were to, say, break my leg or something, my only other alternative would be acetaminophen-based products. If the FDA does this, people like me will have no relief!

  27. The heroin dealers are gonna love this one.

  28. Marijuana is a pain med.

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  30. This is a HORRIBLE piece of journalism. The author(s) are taking two entirely separate issues and trying to build one off the other. Yes, worries about opiate addiction are way overblown but its a subject that has absolutely NOTHING to do with the proposed removal of certain painkillers from the market. The panel simply stated that they feel the inclusion of acetaminophen in many of the current crop of opiod analgesics is not healthy. They are NOT calling for the removal of these meds entirely, just one (and less important) part of it. The manufacturer would *probably* just change the formulation to a less onerous substance leaving the opiate portion intact. But did Reason infer this at all? No. They attempted to create some kind of moral outrage by inferring that the whole class of opiod analgesics would be wiped from the market. If that wasn’t bad enough the author(s) threw in the addiction angle which has absolutely NOTHING to do with the panel’s suggestion.

    Evidently “Reason” doesn’t have anything to do with the term “rational” here.

  31. I am allergic to asprin and ibuprophen. When I take it, my lips swell for several hours. So when I have a toothache or if I were to, say, break my leg or something, my only other alternative would be acetaminophen-based products. If the FDA does this, people like me will have no relief!

  32. really good,
    when I have a toothache or if I were to, say, break my leg or something, my only other alternative would be acetaminophen-based products

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    I am allergic to asprin and ibuprophen. When I take it, my lips swell for several hours. So when I have a toothache or if I were to, say, break my leg or something, my only other alternative would be acetaminophen-based products. If the FDA does this, people like me will have no relief!

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  39. The govt wants to lie about how bad Vicodin is just to push out their new meds like lyrica cymbalta and savella just so we take the new stuff and destroy our immune systems and damage us Vicodin is fine for me I do not abuse it and have absolutely no side effects at all I had horrible side effects from lyrica my doc wont write no more Vicodin or pain meds beside darvocet which contains 650 mg of tylenol which they say is so harmful then why not just write norco which only contains 375mg of tylenol and works a hell of a lot better I suffer from severe fibromyalgia and I’m getting extremely tired of feeling like this every day my doc says pain meds don’t help yea OK I wouldn’t ask for them if they didn’t

  40. They are very convincing and can definitely work. Still, the posts are very short for novices. May just you please lengthen them a bit from subsequent time? http://www.apple.com/ipod/start

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