Prescription painkillers and the opioid crisis. Trying to get a clear understanding of the relationship between Prescription Painkillers and the Opioid Crisis has, for a long time, been a difficult journey in which consensus has been a circuitous, moving target. Theatlantic.com has taken a lengthy and clear-eyed look at the issue, from the earliest days of the dawning awareness that a new and devastating social ill of opioid addiction was proliferating, through today, where the long held professional opinions on the best way to treat opioid-using pain patients is undergoing profound reconsideration.
It a true deep dive on the subject, but if you take the time to read it, you will gain a fuller understanding of why it’s been so difficult for many to even begin to understand all the complex factors that must be integrated into efforts to alleviate suffering without exacerbating the challenges of the addiction rehabilitation process.
In the early days of the opioid crisis, public officials had reasons to blame it on all the pills. News stories featured people who, to the shock of their neighbors and loved ones, had died unexpectedly of a drug overdose. In an emergency, authorities do what they can with the tools at hand. In tightening controls on doctors who prescribed pain relievers, state and federal agencies were focusing on the aspect of the problem most subject to regulatory intervention.
To some degree, that strategy worked. According to the Centers for Disease Control and Prevention, overdose deaths declined by about 5 percent in 2018—a dip attributable almost exclusively to fewer deaths from oxycodone, hydrocodone, and other prescription opioids. (Fentanyl deaths are still climbing.) Now that the fever of the opioid crisis may be breaking, Americans can revisit some of the stories we have told ourselves about the role of prescription medication in the crisis.
By now, the outlines of the story are familiar: Opioid prescribing began to rise in the early 1990s, powered by two forces. One was a campaign by oncologists and pain specialists to correct the undertreatment of pain. The other was the introduction in 1996 of the potent time-release oxycodone medication Oxycontin, which the drug company Purdue Pharma vigorously marketed to doctors.