Pain Epidemic: Are Narcotics The Cure Or The Cause?

By Fred J. Von Stieff, MD, AAFP, ABAM, CSAM, ASAM

doctor holding water and pill

An estimated 90% of the narcotics produced worldwide are consumed right here in the United States, according to distinguished researcher and addiction expert Mark Gold, M.D. Why does that matter? Because in the near future, the U.S. will be faced with an unprecedented dilemma: A pain epidemic. Millions of Americans will be unable to find relief from the various aches and pains incidental to advancing age because of the current over-prescription of narcotics.

This dilemma, however, can be adverted through education. Doctors and patients alike must be informed about the dangers of over-prescribing narcotics. Narcotics like methadone, Suboxone, and Subutex are prescribed by well-meaning Doctors in alarming quantities to cope with pain and to detoxify people off other opioids. Following the method of harm reduction, these well-intentioned doctors believe they are saving lives by switching the patients off dangerous drugs such as heroin and putting them on other narcotics. Fully aware that methadone, Suboxone, and Subutex are also opioids, they think it is the only option and that the benefits of getting patients off heroin outweigh the costs of being on these narcotic medications. What they are unaware of, are the long term side effects of this treatment method, the extent of damage this will do to patients’ neurotransmitter systems and all the future implications of that damage.

By using these medications for extended periods of time, they are suppressing, possibly even eliminating the body’s natural ability to cope with pain. To illustrate the concept of suppression, consider a young woman who has suppressed her ovulatory cycle through birth control pills for ten years. These pills have worked by suppressing her pituitary-ovarian axis. Once she stops taking the birth control, it would be unrealistic to expect her to be immediately fertile again. Suppression has taken place, and it will take a while for the woman to return to being fertile. It is similar with the suppression of the opioid system; after coming off the narcotic medications, it takes a while for the natural opioid system to work again, if it ever does.

Neurotransmitters are the chemicals within our brain that cause us to experience various feelings and sensations. There are different neurotransmitter systems and each system produces unique reactions. The opioid system in particular is in charge of fighting pain. Any time the body gets hurt, its natural response is to increase opioid production to manage the pain. These opioid neurotransmitters, also known as endorphins, are essentially the body’s natural narcotics. However, when a person takes narcotic medications, like Suboxone, Subutex, oxycodone, methadone, or morphine, the body stops producing its own opioids/endorphins. Taking these narcotic medications over a long period of time means long-term suppression of these endorphins, resulting in damage to the body’s natural opioid system that may be permanent

The question then becomes, when patients’ own pain-fighting neurotransmitters are left ineffective, and their tolerance is built up to all the narcotic medicines out there, what is left? The future looks pretty bleak.

Why hasn’t this damage been publicized? These narcotic medications are still too new. Decades of use is often needed to prove a medication’s danger. I have worked as the medical director of three chemical dependency units over the past two decades and I have witnessed the damage of these narcotics. For ten years I, myself, prescribed Suboxone, Subutex, and methadone to patients coming off of other opioid drugs. Using this method of prescribing narcotics to get off of other narcotics was and still is common practice, yet using this method yields a 62 percent relapse rate for patients. After ten years of these terrible odds, I decided I could no longer tolerate such a high relapse rate, and I stopped using these narcotics all together in my practice, replacing them with other more effective medications and methods. I explain this method in my book, Brain in Balance: Understanding the Genetics and
Neurochemistry behind Addiction and Sobriety.

These narcotic medications and the manner in which they are taken are so damaging to patients, that it is easier to detoxify five patients off of heroin daily than just one patient off of Suboxone and/or methadone. When someone is on heroin, the effect wears off and the individual intermittently battles with withdrawal. Withdrawal is the result of the person’s own opioid neurotransmitter system coming back to life, as it were. That means the body’s endorphins are not being continuously suppressed. A heroin addict comes on and off the high four or five times a day, therefore stimulating the opioid system, which in turn affects other important neurotransmitter systems. However, patients using Suboxone or methadone are continuously suppressing their opioid system, sometimes for years.

When trying to get people off methadone who had been on it for ten or more years, I absolutely could not get them off, due to their increased amount of pain and depression. This pain and depression was the result of the destruction done, not only to the opioid system, but also to the GABA and dopamine systems. The GABA and dopamine neurotransmitter systems are essential to our ability to relax and feel confident. Having damage to these three systems is incredibly detrimental to one’s mental well-being.

Our present practices in addiction medicine of over-prescribing Suboxone, methadone, and other opioid medications are having disastrous effects that will not fully be felt until decades to come. Doctors today are still largely unaware of the severe suppression and chronic problems that are resulting from the long-term use of these narcotics because these unintentional consequences remain undocumented. There is virtually no literature on the matter because it is unethical to do human studies on these patients, therefore the consequences go hidden. If doctors do not change their methods, we will be facing a fierce pain epidemic in the near future.

World-renowned Addictionologist, Dr. Fred J. Von Stieff has handled virtually every kind of substance abuse case there is. His pioneering methods of steering clear of narcotics and focusing on neurotransmitter balances throughout treatment has met with unprecedented success. He not only treats patients, but also educates them on the best ways to avoid relapse and take control of their health. He also educates fellow medical professionals on
the best way to lead patients to a life of sustained sobriety. You can read about his methods in his groundbreaking book, Brain in Balance: Understanding the Genetics and Neurochemistry behind Addiction and Sobriety, which can be found on Amazon. His next upcoming book will focus specifically on treating opioid addiction.