The idea of opiods as a gateway drug to me is a red herring, the problem is they are addictive themselves, not that they lead to heroin use.
I don’t think anyone is saying that opiods should be banned, that isn’t the point, when you have someone in chronic pain like the poster with the husband with the back that is fusing or someone with pain from cancer or some other condition, it is kind of stupid to argue we shouldn’t give them relief because they will become addicted, when someone is in severe pain that is frankly stupid. My mom told me the story of an uncle of hers dying of cancer back in the late 50’s, he was in end stage cancer and was in agony, and remembering the family asking the doctor about upping his morphine dose, and the doctor worried he would get addicted…which while I appreciate the sentiment, is ridiculous.
The problem we are talking about happening would be the over prescription of these drugs, whether it is prescribing a 30 day supply rather than a 2 day supply, or prescribing it without perhaps prescribing something less dangerous to see (these days you can get a prescription sent electronically to a local pharmacy, if pain med isn’t working then you go to the next step). In some ways it is like the over use of antibiotics, which while it has tapered off, was a real problem (sorry, the superbugs out there are not a myth, and they can be traced to the overuse of antibiotics in both people and worse, in meat production),. Often that happened when someone would come into a doctor’s office complaining of something, doctor takes a look, and says “It is viral” and the patient insisting and getting anti biotics (and this has been documented, folks, there are studies out there about why/how they get overprescribed), not all but enough doctors saw them as ‘magic bullets’ rather than something to be used as sparingly as possible.
Someone hit the nail on the head, that the practice of pain management is not that well understood, there are a lot of variablest to how people react, everyone is different, I react strongly to pain meds (tylenol3 which is tylenol with codeine in a very low dose made me loopy, I once had percoset and was somewhere out near pluto), and generally don’t need more than aspirin or ibuprofen, my wife had gum work done and percoset didn’t help her much. I think there is a tendency to assume the worst and call out the big guns for most people (and that is just my impression, not scientific).
The reality is that we have a raging problem with Opiod addiction and while probably a large percent is fed by the illegal drug trade that in turn is fed by the Mexican Cartels or by shady operators on the fringes of the legal side of things, but there are also a lot of people ending up hooked because they initially got it legally (Rush Limbaugh, anyone, he who once upon a time used to say shoot all the drug addicts, to heck with rehab?). No, doctor’s overprescribing these is not the major cause but it is part of it, kids are getting hooked because mom or dad got a 30 day supply, they get left around, when maybe a 2 day supply would have been smarter, and we need to investigate the whole thing. I have no confidence with Christie being the ‘tsar’ of this, he claims to be compassionate towards those hooked but his tenure in NJ as governor has not shown him doing much other than proclaiming there is a problem, and his answer was laden with war allusions ie going after supply and arresting those in possession of it, rather than trying to drop it by trying to figure out why it is happening and tackle multiple paths.
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