The medical community, largely lead by pharmaceutical companies, embraced the aggressive treatment of pain with narcotic medications.  Led by the Joint Commission, which certifies hospital and other health care institutions, pain was called the 5^th vital sign.  Thus, like life sustaining functions temperature, blood pressure, respiratory rate, and heart rate, pain was to be constantly monitored and aggressively managed.

The tool to manage the pain was narcotics.  Long lasting and short acting narcotics were readily dispensed to solve any pain problem.  Patients were regularly transitioned from short acting to long acting narcotics.  Then, when these proved less effective, patients were transitioned to synthetic opioid patches.  The Joint Commission encouraged this escalation by including pain management in its metrics for patient satisfaction.

Moreover, the medical community, encouraged by pharmaceutical companies, was beset with basic misunderstandings about these drugs.  These basic misunderstandings were set forth in the bible on this subject: a 2001 report by the Joint Commission entitled, “Pain: Current Understanding of Assessment, Management, and Treatments.”  This report adopted many mistaken recommendations, including:

• Sustained release opioids are effective against long term pain.
• Sustained release narcotics are not addictive, and thus their long term use is safe.

These basic assumptions were made without adequate study, and they proved to be dangerously false. 

We now know that these drugs are dangerous.  They are highly addictive.  Moreover, their effectiveness for long term pain management is dubious.  Patients require higher and higher doses and receive less and less relief.   So, in the effort to increase patient satisfaction, doctors created millions of opioid attics.

Since 2000, the rate of deaths from opioid drug overdoses increased 200%.  Shockingly, in 2014, four times more people died from opioid overdoses than car accidents.  

Then, the medical community, appreciating the dangerous of these medications, put the brakes on their prescription.  Patients that have been taking these addictive medications for years have been told their prescriptions will be stopped within the next 30 days.  Stopping these medications, however, did not miraculously cure their patients of their serious addictions.  Previously law abiding patients have been forced to seek opioids any way they can, often illegally.  Of course, unmonitored use of these dangerous drugs increases the risks of overdose and death. 

The bottom line is narcotic pain medications are proven effective for short term pain management.   Long term use is addictive, and the longer these are used the greater the risk of addiction and overdose. Any time you are prescribed these medications, you should take great care to limit your exposure.