I'm definitely in the boat that opioids lack the data necessary to determine long term benefits of pain control... But... There isn't much else available for long term pain control either. What else do we have? On the one hand, I don't blindly think that pharmaceuticals are out to save lives and that money is not the main motivator which causes a lot of corrupted (coughbayerHIVscandalcough) incidents and money will always lead to bad decisions made in its namesake... on the other hand, it literally IS saving lives, there are very passionate people trying to work their tails off and doing a ton of school and work just to try to make something better than what's available, and .... To be honest, if you're going to be addicted to pain pills, I'd rather them be regulated doses of something measurable vs whatever you can buy off of the street.
In psych 101 they distinguish dependency vs addiction for a reason. I think it's an important one to make.. and being a nurse, I see these two definitions blurred together into one mass all the time. Dependency on hypertension medications or pain medications means there is something medically indicated for taking them. Addiction tends to be less medically driven--though it can certainly stem from medical roots and frequently does.
If you've never seen cancer, it is sometimes an extremely painful thing to live with, and the long term side effects of pain medications, even dependency being one of those, is worth it for quality of life. And... we don't have much to offer them. I'm really thankful we can control their pain as well as we can even if it isn't perfect by any means. But over prescribing medications is a very real and serious problem. And it's multifaceted. It isn't JUST about making money off of pain meds. Patients themselves motivate a lot of this as well.. think of the number of times you felt frustrated that you went to a doctor's office only to be told "meh, it's fine, itll work itself out of ya." I've seen a number of patients pissed off they didn't get SOME kind of medication to help. They demand antibiotics for what is most likely a viral infection. They demand pain control even though the surgery they got is a minor one. And medicare is in the camp now that patient satisfaction is a big determining factor in whether or not that hospital gets reimbursed for the money they spent on that patient.
To say that "pharma is evil and corrupt" ... there is a lot of facets to this puzzle, and a sweep of the hand into a black and white "good/bad" doesn't really do any good. It isn't an evil boss battle in a game. It is a machine, and it does need a lot of rebuilding to make it work efficiently for people. And there are some pretty genuinely nasty people with what I could even consider to be evil ideas that want to prevent some of those rebuilds lest they give up their current cushy quality of life... But.. to say people don't drive the industry and only the industry wants people's money is sorely naive as well.
I'm excited about research like neuro-disrupting machines that can relieve leg pain without medications, and innovations like that. I think we should all strive for learning to deal with pain, and being mindful of the smaller, free-er fixes for pain problems.. but the reality is, compliance and interest is not always there with these things. People want magic bullets, and we don't have them. And trust me when I say, pharma wants magic bullets too.
I think people tend to 'defend' pharma because... honestly, people are SO quick to condemn it. It isn't like saying "It isn't evil" is the same was it's perfect. I don't think anyone passionate about medicine overlooks its glaring flaws. In fact, most often the emphasis on medications IS on the flaws, because those flaws are the most important aspect of patient care. Macroscopic scopes usually open one's eyes up to what one wants to see... It's hard to take in a whole vista, so you focus on a mountain, or the sky, or a river in it... Similarly, if you want to see evil in the pharmaceutical industry, it is really easy to find.. but so too is good. People do need to educate themselves and not blindly listen to doctors.. but with a grain of salt, and an understanding that those doctors are highly trained in their professions for a reason. You really can do the scientific method with your own care in a way that is fair to both yourself and trained professionals.
