By Pat Anson, PNN Editor
A new study by the Centers for Disease Control and Prevention has found that over half of people who misuse prescription opioids also binge drink, increasing their risk of dying from an overdose.
“We are losing far too many Americans each day from overdoses,” CDC Director Robert Redfield, MD, said in a statement. “Combining alcohol and opioids can significantly increase the risk of overdoses and deaths.”
Binge drinking and misuse of opioid medication are never a good idea, whether done separately or in combination. Unfortunately, the CDC study is written in ways that mislead and further worsen the stigma associated with prescription opioid use. And it fails to acknowledge the role CDC itself has played in the growing use of alcohol for pain relief.
The study, published in the American Journal of Preventive Medicine, is based on survey of over 160,000 people who participated in the National Survey on Drug Use and Health from 2012 to 2014. Based on their answers, CDC researchers came to some sweeping conclusions about the number of Americans getting high on pills and alcohol.
“More than half of the 4.2 million people who misused prescription opioids during 2012–2014 were binge drinkers, and binge drinkers had nearly twice the odds of misusing prescription opioids, compared with nondrinkers,” researchers said.
“Prescription opioids were responsible for approximately 17,000 deaths in the U.S. in 2016. One in five prescription opioid deaths also involve alcohol.”
The statement that prescription opioids “were responsible” for 17,000 deaths is misleading because it is based on data from death certificates and coroner reports that only indicate the medications were present or “involved” in overdoses. Other substances were more likely to have played a role or even caused the deaths. In 2016, over 52,000 fatal overdoses involved heroin, illicit fentanyl, cocaine or methamphetamine.
And who were the people who misused prescription opioids? They were recreational users of pain medication. “Misuse” in the study was defined as “use without a prescription or use only for the experience or feeling it causes.”
To be clear, legitimate patients with legitimate prescriptions are not more likely to binge drink. And binge drinkers (four or more drinks by a woman, or five or more drinks by a man) are not more likely to have an opioid prescription. Those basic facts tend to get lost in studies like these.
Patients Using Alcohol for Pain Relief
Perhaps the biggest oversight by CDC researchers is the 2012-2014 time frame chosen for their study – which is well before the agency released its controversial 2016 opioid prescribing guideline.
One of the key findings from a recent PNN survey of nearly 6,000 patients is that the guideline has limited their access to prescription opioids so severely that many are turning to alcohol for pain relief. Nearly one out of five patients surveyed said they had used alcohol for pain relief since the guideline came out.
“It has caused many pain patients to be cut off their pain medication,” one patient told us. “After losing my meds 16 months ago, I just started using alcohol and I never used alcohol. I don’t like alcohol, but what are my options?”
“Since my doctor stopped prescribing even my small amount of opioids I deal with days where I can’t even get out of bed because I hurt so much and I’m stuck turning to alcohol, excessive amounts of acetaminophen and NSAIDs,” another patient said.
“The CDC guidelines are killing people,” one woman wrote. “My fiancé has been refused even the most mild stenosis treatment because he admitted using alcohol to treat his pain when he has no other treatment. He’s mildly suicidal as well. We have two young kids.”
“I lost a good friend to suicide because she was not able to get pain medications to relieve her pain and it was too much for her to handle,” a patient said. “Sadly, she is not the only one. I’m hearing about more and more. I’m also hearing about people turning towards alcohol.”
“All they are doing is pushing chronic pain patients to find relief in other ways such as alcohol, illicit drugs or harming themselves to get the pain relief they do desperately seek,” wrote another patient.
The PNN survey found that 26% of patients had used medical marijuana for pain relief, 20% had used kratom and 4% had used street drugs such as heroin or illicit fentanyl.