The Opioid Epidemic Ground View [...]

This is what the Pain Pill Epidemic looked like from the ground:

When I started working as a medical resident, in 2004, I heard from a patient I had inherited from a graduating resident. The patient had an appointment scheduled in a couple weeks. “But I need your help now,” he said.

He was a former construction worker who had hurt himself on the job a couple of years earlier. He told me, “I also need some more OxyContin to tide me over until I can see you.” The hospital computer system told me that he had been taking twenty milligrams of OxyContin, three times a day, for at least the last couple of years. I had rarely seen such high doses of narcotics prescribed for such long periods of time. I’d seen narcotics prescribed in the hospital to patients who had been injured, or to those with pain from an operation or from cancer. But I didn’t have much experience with narcotics for outpatients. I figured that if the previous resident—now a fully licensed doctor—was doing this, then it must be O.K.

What I didn’t know was that my time in medical school had coincided with a boom in the prescribing of narcotics by outpatient doctors, driven partly by the pharmaceutical companies that sold those drugs. Between 1999 and 2010, sales of these “opioid analgesics”—medications like Vicodin, Percocet, and OxyContin—quadrupled.


One issue with chronic use is chronic use can actually increase sensitivity to pain. See Hyperalgesia

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