As a physician in the 1990’s in Vermont, I heard the sales pitch for Oxy Contin. I am an Ob/Gyn and didn’t think the medication applied to my patients. It seemed like a strong drug for patients dying of cancer. I never wrote a prescription for it.
I did note that many colleagues wrote for it, as well as, many other opioids. I would hear of people going home with 40 oxycodone pills for a wisdom tooth extraction. A fellow Ob/Gyn, was chastised for crusading against over prescribing. People were given pain meds for headaches, menstrual cramps. A local physician was known for just writing a script for the most minor complaints, mostly to poor patients who didn’t have access to yoga, massage or physical therapy.
I trained in an urban center, Buffalo, NY. Many rotations were at the ECMC trauma center. Physicians there warned me of the risks of opioid pain medications. Oxycodone for back pain was just going to create a worse situation, it might be great for a few days but, in the long run the price was too high.. I often thought, we are creating use disorder for the patients being prescribed. What I never saw coming, was that the medicine cabinets in Vermont would be filled with these powerful dangerous drugs, often just kept on hand, just in case. That the victims, would actually be, the curious adolescents in the home.
My husband broke his ankle in 2010. It was pretty bad, he needed surgery. My husband was given three large prescriptions for a powerful opioid, #120 pills , three separate doctors wrote prescriptions. He took one tablet, and threw the rest away.
After all, our son struggled with substance use disorder and was fighting hard to stay sober at that time. He ended up relapsing, not on any of the medication my husband was given (we kept it in a safe), just knowing the pills were in the house triggered him. He stole a bank card and ran away. he went missing for several weeks. We didn’t prosecute him, we offered treatment instead. It was one of the happiest days of my life, flying home from Minnesota, with Sean safely enrolled in a inpatient treatment program.
Sadly, most people I know with SUD have started with oral pain meds, prescribed sometimes, sometimes taken at a party.
The research by Sam Quninones for “Dreamland: The True Tale of America’s Opiate Epidemic” is an excellent resource for the absolute, reckless marketing of the new “pain vital sign” and ensuing campaign to coerce physicians into prescribing these dangerous drugs, all the while telling us they weren’t addictive.
I am grateful, I didn’t write for this medicine. I just wish my colleagues would have been more judicious. They wrote the scripts that are killing our kids. Most didn’t mean to create an epidemic. They just believed what they were told by the marketing campaign. Then, there are a few who knew darn well what they were doing and created the pill mills that added fuel to the fire.
There are complex issues at hand, reasons people become dependent, of course. Many pharmaceutical companies do develop useful drugs for cancer, or heart disease. I just have to wonder how differently the situation might be if we didn’t have massive flooding of our communities by a pharmaceutical companies looking to make a buck, or a few billion