Addiction and Dependency – PART 3

ADDICTION is a topic I’ve written upon, time and time again, particularly addiction to prescription painkillers. It’s been an issue that I feel passionate about, not the least because it’s something that has had a personal impact upon my life (It was indicated in my last article that I will examine a recent CNN programme on this issue).

Last week, even as I am currently undergoing treatment for chronic back pain, I received a sobering revelation via a Sanjay Gupta special on painkillers aired on CNN. One of the first things that I learnt was presented in the first five minutes or so of the show, which is that prescription painkillers is the leading cause of accidental death in the United States.

Mr. Keith Burrowes
Mr. Keith Burrowes

The story Gupta focused on was that of a promising young lawyer, and family friend of former President Bill Clinton, Ben Gupta (no relation to Sanjay) who died suddenly one day after falling asleep on his couch. The autopsy revealed the cause of death as a combination of alcohol and the prescription painkiller, Oxycodone.
“Now, this man that he’s [Clinton] talking about wasn’t an addict,” said Gupta, “perhaps just a little reckless. He mixed his Oxycodone (0.4 within the medical limit) with a few beers, in fact. The autopsy would ultimately show that he wasn’t legally drunk, didn’t have that much to drink. But the combination was enough to kill him.”
Let me state that here I’m aware that I can be accused of unwarranted panic-mongering or, worse yet, irrelevance when it comes to writing about a distinctly America public health concern. After all, as Gupta revealed in his interview with Clinton, 80 percent of the world’s pain prescriptions are used in America, astounding when you consider that America has only about five percent of the world’s population.
My response would be that it is relevant to us for two key reasons. The first is that the issue should be relevant to Guyanese because I know of no one in Guyana who does not have some relative residing in the US. If prescription painkillers are the leading cause of accidental death in America, then your loved one is more in danger of them than of dying in a car crash.
The second reason is what Clinton said about the nature of the phenomenon, that it was a cultural problem. “You know, people think,” said Clinton, “oh, I got a headache or I got this, my elbow is sore, or whatever. And, look, I don’t want to minimize, there are a lot of people who live courageous lives in constant pain. They’re in pain all the time, for reasons they can’t control. They need relief and they should get it. But there’s no question, since we represent 5 percent of the world’s people, and far less than 80 percent of the world’s people with above- average incomes, we got no business popping as many pills as we do.”
We acknowledge that American’s cultural influence, whether we see it as incidental or deliberately imperial as impacting, through the television set we learn what clothes we should wear to keep up with trends in the US, we learn what sort of countertops we want in our new house when our house lot application comes through, we learn what new star to look out for on American idol, and also what medications work best for our ailments. I would bet that during the average American television show, about one in five advertisements is for some sort of pain relief medicine, prescription or over the counter. Shaquille O’Neal, who appeared on the second half of Gupta’s show to talk about how he deals with diabetes, is also, interestingly, the spokesperson for a pain relief rub, Icy Hot. If the demand for painkillers in America is a cultural phenomenon, then in my view, it is a cultural phenomenon that will be on the verge of being exported here, sooner rather than later.
In some ways, I believe that we have already entered that sooner stage. Addiction is premised primarily upon access (this is my non-medical view), and while the cultural phenomenon of prescribing painkillers is not yet upon us as a society, I am completely aware that addiction to painkillers is already a growing problem among those who have easy access to them in Guyana. When I looked at how simply, how senselessly Ben Gupta died – the combination of Oxycodone and a few beers – and I consider the access some in Guyana have to prescription painkillers, combined with Guyana’s hard-drinking culture, I cannot help but fear a public health crisis waiting to erupt.

(Mr. Keith Burrowes)

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