The one thing to be said for the ads for Super Bowl 50 was that there was no preachy-feminist "Like a Girl" spot as was the case with last year's Super Bowl. I guess the ad-makers decided that either there wasn't much of a market for monthly pads among the Super Bowl's overhwelmingly male viewers–or that trying to police other people's language via I Am Woman cutesiness is kind of like throwing like a girl.

Instead this year there was…gross. And gross says something pretty… gross about our culture. As Business Insider reported:

It was somewhat surprising — among the sodas, and cars, and big name consumer goods brands — to see an ad about constipation airing during the Super Bowl this year. And then to see another referencing diarrhea!

But, yes, it did actually happen.

The first ad (above) promoted a prescription product to help tackle opioid-induced constipation (OIC). It was courtesy of Astra Zeneca….

Then came an ad for Valeant's diarrhea relief Xifazan product, starring its brand mascot: A smiley pink intestine!…

Then, not in the same body area but still in the general gross medical ad department came Jublia in the fourth quarter, returning to the Super Bowl with an ad promoting its toe fungus cream. Lovely!

Now, first of all, dear admakers, most people are eating while watching the Super Bowl. Those famous "Super Bowl snacks". And you don't want to hear about intestinal malfunctions when you're reaching for that second slice of pizza. You really don't.

Second, here's some connect-the-dots moralizing. Constipation is a nearly inevitable side effect of taking anything that's either opium-derived (such as heroin) or opium-like, such as that range of prescription painkillers whose brand-names we all know well: OxyContin, Percocet, Vicodin. If you have OIC, you have opiods in your system–and nearly all the time, it's vice versa.

Opioids are supposed to be prescribed for the relief of severe pain. But as WebMD warns, "[T]here is a risk of addiction when you take them for more than a few days." And the National Institute on Drug Abuse does not have pretty things to say about prescription-opioid addiction:

It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[2]   The consequences of this abuse have been devastating and are on the rise.  For example, the number of unintentional overdose deaths from prescription pain relievers has soared in the United States, more than quadrupling since 1999.  There is also growing evidence to suggest a relationship between increased non-medical use of opioid analgesics and heroin abuse in the United States.[3]  

That's because heroin is a lot cheaper than a prescription opioid, this much cheaper, according to USA Today:

An 80 mg OxyContin can cost $60 to $100 a pill. In contrast, heroin costs about $45 to $60 for a multiple-dose supply.

The National Institute on Drug Abuse reports:

Several factors are likely to have contributed to the severity of the current prescription drug abuse problem.  They include drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies.  These factors together have helped create the broad “environmental availability” of prescription medications in general and opioid analgesics in particular.

To illustrate this point, the total number of opioid pain relievers prescribed in the United States has skyrocketed in the past 25 years  (Fig. 1).[4]  The number of prescriptions for opioids (like hydrocodone and oxycodone products) have escalated from around 76 million in 1991 to nearly 207 million in 2013, with the United States their biggest consumer globally, accounting for almost 100 percent of the world total for hydrocodone (e.g., Vicodin) and 81 percent for oxycodone (e.g., Percocet).[5]

This greater availability of opioid (and other) prescribed drugs has been accompanied by alarming increases in the negative consequences related to their abuse.[6] For example, the estimated number of emergency department visits involving nonmedical use of opioid analgesics increased from 144,600 in 2004 to 305,900 in 2008;[7] treatment admissions for primary abuse of opiates other than heroin increased from one percent of all admissions in 1997 to five percent in 2007[8]; and overdose deaths due to prescription opioid pain relievers have more than tripled in the past 20 years, escalating to 16,651 deaths in the United States in 2010.[9]

I'm not going to point any fingers of blame here, and there are undoubtedly plenty of sufferers from chronic pain who are willing to put up with addiction as the price for relief (or maybe they're too addicted to be able to stop). But 207 million painkiller prescriptions is a lot of painkiller for a country with a population of 300 million. It's not surprising that Bill Maher promptly tweeted after the OIC ad: "Was that really an ad for junkies who can’t sh–? America, I luv ya but I just can’t keep up."

Cruel, maybe–but it says something negative about a culture in which the "cure" for a problem caused by a drug taken purely voluntarily is yet another drug.

And another expensive drug at that. The Super Bowl ad was billed as strictly for "educational purposes," but the information on the OICisDifferent website the ad promoted comes straight from AstraZeneca, maker of the aptly named Movantik, a "treatment" for OIC, and a click button on the website leads straight to an ad for–guess what?–Movantik. The pricetag on a single month's supply of Movantik is more than $300.

Why can't we go back to the fun commercials that used to make the Super Bowl ads as entertaining as the Super Bowl game?