Contrary to popular belief, people most inclined to abuse opioid painkillers are people who suffer from childhood trauma and mental illness -- not those who suffer from chronic pain like Prince.
The problem of prescription drug abuse became a focus of national interest after the death of Prince, who passed away last month at his Paisley Park property in Minneapolis. But while the media has widely reported he died after becoming addicted to painkillers, Prince had a medical condition -- chronic pain.
Though an enigmatic music legend, Prince suffered from a relatively mundane workplace injury. He had damaged his hips from years of performing. Chronic pain requires treatment with powerful medications, and patients suffering from it are no more "dependent" on their medication than diabetics are to insulin.
But the stigma being generated by the death of such a widely-loved musical giant shouldn't be levied against patients who deal with chronic pain, or the doctors who responsibly treat them. According to Scientific American, these patients are the least likely to become drug addicts.
That's not to say opioid addictions and overdoses aren't a serious problem. They take the lives of 29,000 Americans every year. But Scientific American points out this is largely driven by illicit, not medical, drug use.
Citing the annual National Survey on Drug Use and Health, the magazine reports that "75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer."
A whopping 90 percent of all addictions, regardless of the drug, start in adolescence or early adulthood, and people who abuse prescription drugs are often heavy users of alcohol and other substances. Per the Scientific American:
In general, new addictions are uncommon among people who take opioids for pain in general. A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care; a less rigorous, but more recent review put the rate of addiction among people taking opioids for chronic pain at 8-12 percent.
Moreover, a study of nearly 136,000 opioid overdose victims treated in the emergency room in 2010, which was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition.
Major risk factors for illicit opioid use are childhood trauma, mental illness and poverty. And because the addictive misuse of the pills exists largely outside the realm of prescription and medical treatment, renewed calls to regulate powerful painkillers in the wake of Prince's untimely passing may not be the answer.
Instead, Scientific American points out, we'd do better as a society by addressing the true roots of prescription drug addiction. They're a bit more complicated and mirror those of other addictions.
"Two thirds of people with opioid addictions have had at least one severely traumatic childhood experience," and further, "at least half of people with opioid addictions also have a mental illness or personality disorder."
The final risk factor is poverty. Heroin addiction rates skyrocket by 3.4 times for people making less than $20,000 yearly, versus those making more than $50,000.
"Many people would prefer it if we could solve addiction problems by busting dealers and cracking down on doctors," the Scientific American concludes. "The reality, however, is that as long as there is distress and despair, some people are going to seek chemical ways to feel better."