Doctors and patients face a painkiller crisis, even as they fight COVID
Surgery is never fun. But surgery during a global pandemic is an especially frightening prospect. When I went under the knife for a corrective hernia procedure recently, COVID-19 got added to the long list of potentially fatal outcomes I had to worry about.
Long list? Yes: The operating room and I go way back, which has left me with a lot of risk factors. I had open-heart surgery a decade ago to fix an aortic aneurysm and calcified valve. I have a titanium valve in my chest. I’m also on blood thinners, that means I can’t take traditional NSAID painkillers like ibuprofen, aspirin, and naproxen, because their side effects—which include gastrointestinal perforations and bleeding—could seriously injure or kill me. And I don’t want to take opioids, which pose the risk of addiction, not to mention severe constipation and a host of other side effects.
When I went under the knife, I had to make do with acetaminophen, which just isn’t suitable for durable pain relief—and does nothing for the inflammation that follows surgically injured tissue. It hurt like hell.
I wish I could say that my experience was unique, but many others face the same kind of pain and the same kind of choices around its treatment—8 million Americans take blood thinners, according to a recent report from Pharmacy Times.
However, as chief medical officer of a pain-focused biotech research company, I have better than usual line of sight into the requirement for medications for acute and chronic pain. And if I’ve learned one thing, it’s this: Society needs new drugs and remedies that don’t turn common ailments or routine health care procedures into unnecessary gambles.
It’s hard enough to be unable to use NSAID pain relievers after surgery. But there’s also chronic pain, which a quarter of all adults suffer from in one form or another. Again, my own story is relevant and not unusual. I experience regular pain throughout my body stemming from teenage sports and military service injuries, and due to the simple fact that I’m aging. For anyone with multiple risk factors, the wrong decision about what pain pill to take could have severe consequences. We need to seriously weigh the pros and cons of everything we ingest.
Many of us try opioids, which are often used for moderate to severe pain. But that risks turning even more people into statistics in North America’s raging addiction crisis. Opioids were a factor in two-thirds of America’s 72,000 drug overdose deaths in 2019.
In my previous life as a U.S. Navy doctor, I moonlighted in various North Philadelphia primary-care settings and rural clinics, where I saw the real and devastatingly human impact of opioids close up. They’re addictive—plain and simple. Even light misuse can lead to serious neurological effects, including coma, brain damage, or death—not to mention the persistent stigma around addiction. Medical professionals and pharmaceutical providers need to play a leading role in encouraging addiction awareness and stigma reduction conversations within communities like these.
Pennsylvania farm country, the military, the business world—everywhere I’ve spent time, I’ve seen opioid addiction. The crisis runs rampant in cities and towns, on farms and in mansions, far away and next door. And now, the global COVID-19 pandemic has made the opioid crisis even more deadly, by creating insecurity, isolating users, disrupting the flow of uncontaminated drug supplies, and taxing our health services.
When I had my latest surgery, I was given opioid medications during and immediately after the procedure. But once I left the hospital recovery area, I made the call to live with my postoperative pain, opioid- and NSAID-free, in the name of living beyond it. My decision, and the physical discomfort that came with it, was another reminder of how desperately we need alternative medications.
Fortunately, I’m part of a strong community of biotech and medical professionals looking for nonaddictive pain relief solutions.
As the medical community sprints toward rolling out COVID-19 vaccines in the coming months, we need to keep racing in parallel on the research and development required to introduce effective, lower-risk pain relief. My own company is developing three pain medications that are derived from traditional NSAIDs but designed to be safer for the gastrointestinal system.
We also need to renovate the traditional drug discovery process—a famously lengthy endeavor. We need a model that allows science to do its thing while empowering medical professionals to move quickly from R&D to trial to government approval to deployment phases of bringing alternatives to market.
I believe we’ll get there, just like I believe we’ll beat COVID-19. I am optimistic that future surgeries like mine will be as routine as it gets, even for people with risk factors. To succeed, we just need to make sure that pain is the only thing we’re killing with painkillers.
Dr. Joseph Stauffer is the chief medical officer at Antibe Therapeutics.