BioMed - Status Quo

Pain is the most common symptom for which individuals seek medical help, yet it is often inadequately treated. Chronic pain affects more Americans than diabetes, heart disease and cancer combined (1). The National Health Interview Survey (NHIS) has found that most American adults have experienced some level of pain, from brief to more lasting pain, and from relatively minor to more severe pain.

The effects of pain have caused a tremendous cost on our country. Two large factors that affect the annual economic costs of pain are the incremental costs of medical care due to pain and the indirect costs of pain due to lower economic productivity associated with lost wages, disability days, and fewer hours worked.

Today, the most commonly prescribed pain treatment options are primarily powerful pill-form medications. Since pain is such a diverse clinical condition that can be associated with a variety of causes, there are many commercial drugs available on the market to treat many different types of pain. They are drugs such as opioids (Vicodin, OxyContin, Percocet), NSAIDs (Nonsteroidal Anti- Inflammatory Drugs, such as ibuprofen & naproxen), Tylenol, Aspirin, and many others. Although they can be effective pain relievers if safely used, these oral pill treatments have proven to be as dangerous as they are powerful.

Prolonged use of these oral pain medications can result in many harmful effects, including:

Hyperalgesia: Continued use of opioids can cause hyperalgesia, a feeling of increased sensitivity to pain where a previously non-painful stimulus will evoke pain.
Tolerance: Drug tolerance could occur after prolonged use of opioids, requiring patients to take increasingly higher doses to achieve the same level of pain relief.
Opioid-Induced Constipation (IOC): This is the most common side effect of oral opioids. OIC treatment usually requires additional medications to be prescribed along with the opioid painkillers that are causing the constipation.
Gastrointestinal Bleeding: It is well-known that use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of upper gastrointestinal bleeding (2), sometimes as early as after 8 weeks of use.
Drug Misuse: The use of a drug in a manner other than as directed.
Drug Diversion: When prescription medicines are obtained or used illegally.
Drug Addiction: A dependence on a legal or illegal drug or medication.
Drug Overdose / Death

The use and abuse of opioid and other DEA scheduled medications for the treatment of acute and chronic pain has increased across the country. Addiction, abuse, and mortality due to the abuse of prescription painkillers has reached a state of epidemic proportions in the United States. The consequences of this abuse have been devastating and are on the rise. The number of unintentional overdose deaths from prescription pain relievers has soared in the United States, more than quadrupling since 1999 (3).

Within the last few years there have been major advancements in the healthcare industry to begin to change the universal overprescribing of these potentially hazardous oral pills. Prescribers globally are turning to alternative pain management therapies that are safer and non-addictive. Less-invasive methods of delivery, such as topical cream medications, are helping millions of patients alleviate their pain safely and effectively. The pharmaceutical art of compounding has experienced a renaissance as modern technology and innovative techniques and research have allowed more pharmacists to customize medications to meet a patient’s unique needs.