Your article “Overdosed” in the Feb. 20 issue was accurate and well-researched, and it is a story that has played out across the nation. As a recently retired general practitioner in Palmer, Alaska, I had 41 years of practice to witness the formation of our addicted, chronic-pain and disability culture. More and more patients require huge amounts of opioids for pain control following surgery due to their extremely high tolerance to painkillers.
Back in 1974, when I started practice in the then-mostly rural and agricultural community of Palmer, we saw our occasional Valium, Quaalude, Demerol and amphetamine diet-pill seekers, but nothing of the magnitude seen today. Pain as the “fifth vital sign” came into existence along with the expectation of reducing all pain, usually with opioids. In the ’70s, there weren’t the megadose pain-clinic pill mills, just a few doctors with the reputation of being loose prescribers.
Unethical doctors have seen good money in pill-mill storefront pain clinics with their “pain contracts,” urine drug tests and monthly clinic visits. Little policing has been done by the DEA or our state medical board, except in severely egregious cases. Perhaps the best solution given our present pro-business and anti-consumer protection administration is for Big Pharma and the associated enabling organizations to face the individual and class action suits that Big Tobacco experienced. Awards may help the already addicted with detox and rehab, but those facilities are in short supply. I’m willing to bet that these facilities will become the next big money-making project for a new for-profit industry, with enough desperate families with financial means or insurance coverage wanting to help their addicted loved ones. Of course, prescribing habits of all providers need to be reined in. We’ve contributed to the problem, knowingly or not, with our own prescription pads.
David P. Werner, MD