The current US prescription-opioid crisis is one of the most remarkable examples of medicine going wrong. Last year in the USA more people died from an opioid overdose than died from road traffic accidents, and more than the total casualties in the whole of the Vietnam war. The reasons for this are complex. They reflect a perfect storm of good intentions coupled with prescriber ignorance and commercial greed, occurring in a context of growing economic problems in some parts of the country, lack of social support systems, and individual despair, sometimes manifested by pain syndromes, in people who may well have been depressed. A vicious cycle of overprescribing of strong analgesics such as hydrocodone and oxycodone then developed that began the current opioid problem which has now morphed into the massive use of illicit opioids.
At the time, it was generally accepted that the treatment of pain was quite often ...
