Sanjay Gupta, M.D. discusses pain

S. GUPTA: Former President Bill Clinton’s familiarity with pain killers goes back to when he lived in the White House. 

Have you ever been prescribed a medication like this? 

CLINTON: Well, I did take some painkillers when I tore my — 90 percent of my quadriceps, but I tried to be very careful and I was in a lot of pain. 

S. GUPTA: And years after leaving the Oval Office, he would once again need pain pills. He said he and his doctors were cautious. 

CLINTON: After my heart surgery, you know, when I was — I hurt pretty bad for three weeks so I got some medicine, but I really tried to get off of it as quick as I could and my doctors were really good about it, you know, telling me, you know, take this if it’s killing you, but be careful. 

UNIDENTIFIED FEMALE: Poison Center. This is Rosie. 

S. GUPTA: Be careful. It’s a warning that might prevent call after call pouring in here at the Washington Poison Center. 

UNIDENTIFIED FEMALE: Poison Center, this is Deborah. 

UNIDENTIFIED MALE: I wasn’t getting pain relief so I took too many oxycodone. I, took, um, five 10-milligram oxycodone. And I’m feeling really shaky, light headed. I’m just nervous. 

HURLEY: For the most part this hasn’t been recognized as a national phenomenon or a national problem at all. 

S. GUPTA: Not recognized among the general population and also not recognize among the medical community? 

HURLEY. Exactly. They had no idea that this combination of medications could lead to their death, and in many cases, their doctors don’t recognize the risk to those patients. S. GUPTA: So how did we quietly become a country inundated with pain pills? Some believe it all began when pain was designated the fifth vital sign. 

When you talk about vital signs, typically, someone gets their body temperature measured, their heart rate, their respiratory rate and their blood pressure, but the results of this push to say the fifth vital sign is pain. Never forget about asking someone about their pain. 

You think that fueled this or helped drive this? 

HURLEY: I do. I think physicians around year 2000 started to get pushed to better manage pain. And the physicians in our culture, that means give out more medication. 

S. GUPTA: So pain becomes a vital sign. Laws are passed liberalizing the use of opiods for more than just cancer or chronic pain patients. That creates new marketing opportunities for aggressive pharmaceutical companies. Doctors prescribe the drugs for legitimate reasons but also for conditions that could be treated with much milder medications or with therapy. 

The result, we prescribe enough pain pills to give every man, woman and child a dose every four hours for three weeks. Remember, 80 percent of the world’s opioids are used by Americans. 

Eighty percent. Does that surprise you? 

CLINTON: I didn’t know that. No, because — 

S. GUPTA: Is that a cultural U.S. problem? 

CLINTON: Yes. It is cultural and you know, people think I’ve got a headache, or about this, or my elbow is sore whatever. And look, I don’t want to minimize, there are a lot of people who live courageous lives in constant pain but there’s no question. This since we represent 5 percent of the world’s people we got no business popping as many pills as we do. 

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