Abuse of opium products obtained from poppy plants dates back centuries, but today we are witnessing the first instance of widespread abuse of legal, prescribed drugs that, while structurally similar to illicit opioids such as heroin, are used for sound medical practices.
So how did we get here?
We can trace the roots of today’s epidemic back to two well-intentioned changes in how we treat pain: early recognition and proactive treatment of pain and the introduction of OxyContin, the first extended release opioid painkiller.
Pain as the Fifth Vital Sign
Fifteen years ago, a report by the Joint Commission on Accreditation of Healthcare Organizations, a nationally recognized medical society which accredits hospitals, stressed that pain was vastly undertreated in the United States. The report recommended that physicians routinely assess pain at every patient visit. It also suggested that opioids could be effectively and more broadly used without fear of addiction. This latter assumption was entirely mistaken, as we now understand. The report was part of a trend in medicine through the 1980s and 1990s toward treating pain more proactively.
