Doing Our Part to Mitigate the Opioid Crisis

In 2016, there were a reported 42,000 opioid-related deaths in the US, 40% of which involved prescription opioids. The Centers for Disease Control and Prevention (CDC) reports that from 1999 to 2017 there were over 700,000 drug overdoses and, in 2017 alone, 70,000 people died from drug overdose, with 68% of those deaths attributed to prescription or illicit opioid use1. While the opioid epidemic was only officially declared to be a public health emergency by the US Department of Health and Human Services in 2017, the factors bringing our society to this point are multiple and go back several decades. One issue was the underestimation of the addictive potential of opioid medications. In 1980, The New England Journal of Medicine published a one-paragraph Letter to the Editor in which the authors reported their observation of 12,000 hospitalized patients who received ‘at least one narcotic preparation’, and found that only four patients became addicted. This led to the erroneous conclusion that it is rare for patients treated with narcotics to become addicted, a principle that soon became dogma2. This misinformation persisted, as evidenced in a 2001 monograph published by the National Pharmaceutical Council and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in which they state, “In general, patients in pain do not become addicted to opioids. Although the actual risk of addiction is unknown, it is thought to be quite low.”3 …