When is this country going to wake up--really wake up--to the catastrophe that prescription opioid painkillers have caused since they came into widespread use in the early 1990s?
Before then, deaths related to prescription opioid overdose were practically unknown. In 2013, though, opioids killed 16,235 people; that's approximately half as many as died in traffic accidents that year, and about 2,000 more than were murdered. Both traffic accidents and murder have been declining for years. Painkiller-related deaths quadrupled between 1999 and 2013, according to the Centers for Disease Control and Prevention.
The total toll from prescription opioid overdoses in that time exceeds 175,000, three times the U.S. body count in the Vietnam War.
The United States' massive investment in reducing avoidable deaths from other causes has been undone to a large extent by avoidable deaths stemming from the abuse of opioids, whose trade names include OxyContin, Vicodin and Percocet.
The latest evidence of these drugs' destructive impact comes from the Urban Institute, where researchers investigated the odd fact that death rates from various causes for non-Hispanic white women ages 15 to 54--a usually healthier-than-average cohort--appear to have spiked between 1999 and 2011.
It turns out that prescription opioid overdoses explain half of the phenomenon, according to the recently released Urban Institute study.
This epidemic was brought to you not by Colombian drug cartels or some other nefarious outlaw force but by the American establishment--corporate, governmental and medical--which blessed the wider use of modern opioids in the belief that pain was vastly under-treated and that new, extended-release opioid formulations would not be addictive.
To question that judgment--to suggest that pain is subjective and that encouraging doctors to pass out these powerful pills not just to patients with cancer but also to those with routine lower back problems was a deadly mistake, driven in significant part by the profit motive--is to risk being accused of insensitivity to suffering people.
As Stanford University psychiatrist Anna Lembke explained in a New England Journal of Medicine article (titled "Why Doctors Prescribe Opioids to Known Opioid Abusers"), many doctors give drug-seeking patients what they want to avoid bad reviews on patient surveys and in social media.
Policies and attitudes toward opioids have become more realistic since Lembke's article appeared in October 2012. Yet even after a recent federal-state "crackdown" on opioid over-prescription, the Food and Drug Administration last year approved a new compound, Zohydro, despite a recommendation from an advisory committee that feared it would be too easily abused.
Most U.S. doctors concede that opioids are over-prescribed, and they have become more cautious about prescribing. But most also say they personally are not to blame for the problem, according to a Johns Hopkins Bloomberg School of Public Health study published last year. Pharmacies still filled 207 million prescriptions for opioids in 2013, the most recent year for which data exist, according to the National Institutes of Drug Abuse.
That's nearly triple the number in 1991, and a far, far higher rate of opioid prescription than any other country. The United States accounts for almost 100 percent of world consumption of hydrocodone and 81 percent of oxycodone, NIDA reports. Does this mean doctors in Europe and Asia are indifferent to their patients' suffering?
The slight recent reduction in opioid prescription has contributed to a rise in heroin abuse and heroin overdose deaths as opioid addicts seek a chemical equivalent on the street. Some argue the heroin boom discredits attempts to rein in opioid over-prescription.
This is exactly backward. The real point is how hard it is to wean thousands of people off these powerfully addictive substances and therefore how terribly mistaken it was to distribute them so extensively in the first place.
Editorial on 03/29/2015