By Jeremy Samuel Faust
We learned Thursday that Prince died of an opioid overdose—specifically from fentanyl, a synthetic opioid often prescribed to people who have built up a tolerance to oral opioids. (Fentanyl is more potent than powerful drugs like OxyContin and is most commonly administered via a patch.) While the toxicology report has not yet been made public—and may never be—it’s possible that Prince, who had a reputation for living substance-free but also suffered from debilitating hip and knee pain, got his drugs from his doctor, not a dealer. Why would the legendary recording artist have been prescribed a drug that put his life at risk?
There’s no question that opioids are effective at managing certain types of pain. But American medicine has become far too reliant on the potentially dangerous drugs for the wrong reasons. About 15 years ago, hospital watchdog groups grew concerned that physicians were not taking pain management seriously enough. The solution to this perceived epidemic of pain in the early 2000s was opioids. These strong painkillers became the drug of choice as ibuprofen (the active ingredient in Advil, Motrin, and similar products) had fallen out of favor thanks to overblown concerns about the risks of internal bleeding.
Around the same time, pharmaceutical companies noticed a now infamous study from 1986 suggesting that opioids were less addictive than previously thought. The author of that paper has since publicly recanted its conclusions, calling the sample size of 38 individuals too small. But pharmaceutical companies used this small, now roundly debunked study to convince professional medical organizations, and eventually hospital regulators, that it was safe to give opioids to more patients. Since the early 1990s, the annual number of opioid prescriptions has tripled. Opioid overdose deaths have quadrupled. Today, Americans consume 80 percent of the world’s (legal) opioids, despite accounting for less than 5 percent of the world population.
There’s no single villain in this story. Our dangerous embrace of opioids was the result of the entire medical establishment—including governmental, nonprofit, and pharmaceutical organizations—searching for an answer to the problem of pain. That problem is real: Managing pain, specifically chronic pain, is an essential part of any doctor’s practice. It is terrible to see people suffer and whenever possible and prudent, pain should be treated. And some of the players in this story were driven by real concern for patients’ quality of life. But others, specifically the manufacturers, were driven by crasser motives: the realization that they could make a fortune by pushing for wider use of prescription opioids.
Continue reading by clicking the name of the source below.