But it is the pendulum swings of the public, media, regulatory and health care community's attitudes toward pain that made this strange affair possible. For thousands of years opium was used to treat a wide variety of human ailments including pain, but by the mid-nineteenth century it had become clear to many that, quoting Meiers, the "broad use of opiates carried a price."
By 1900 there were an estimated three hundred thousand morphine (another opium derivative) addicts in the United States, and by the '20s attitudes toward opiates were such that the Harrison Act banned the prescribing of narcotics to those addicted to them. By the late-'30s over 25,000 doctors had been charged with offenses related to the Act. Doctors were even hesitant to prescribe morphine for advanced cancer patients suffering the severest of pain.
Into this environment the movement to treat pain preemptively with powerful narcotics began twenty years ago, in an effort to alleviate the needless suffering of millions of chronic severe pain sufferers, and attitudes swung heavily in favor of aggressive treatment. Pudue's greatest sin was to take advantage of this new pro-treatment environment to heavily market OxyContin, which was approved by the FDA in 1995, for use in treatment of moderate and intermittent pain, breaking it out of the relatively limited hard-core pain community into the vastly more lucrative general population. "Pain Killer: A Wonder Drug's Trail of Addiction and Death" superbly tells the tale of the disastrous results.
A slightly different version of this review appeared in the Cleveland Plain Dealer.
Article comments
1 - sydney smith
Great review. You're absolutely right that the pendulum has swung too far in favor of casual use of powerful narcotics, thanks largely to promotional efforts by Purdue - both directly and through funding of professional pain societies. Looking forward to reading the book.
2 - Eric Olsen
Thanks Dr. Syd, I'm glad it made sense to you. The book, though somewhat clumsy stylistically in parts, is very powerful and compelling.
3 - JoDee
The only way I can get out of bed every morning is with 40 to 80mg of Oxycontin and for break through pain oxycodone. I view these as life savers for my Interstitial Cystitis, MS, IBS, Fibromyalgia and others. Thank you Dr. Meier.
4 - brenda mcguire-sexton
please do a follow-up book, as the abuse and death rates continue to soar. also it is very interesting how the state of west virginia actually collected from purdue pharma. i live in carter county ky. where i have lost count of the deaths due to od's. many families i have known personally.