The medical field of treating chronic pain is still in its infancy. It was only
in the late 1980s that leading physicians trained in treating the chronic pain of terminally ill cancer patients began to
recommend that the "opioid therapy" (treatment involving narcotics related to opium) used on their patients also be used for
patients suffering from non terminal conditions. The new therapies proved successful, and prescription pain medications saw
a huge leap in sales throughout the 1990s. But opioid therapy has always been controversial. The habit-forming nature of some
prescription pain medications made many physicians, medical boards, and law enforcement officials wary of their use in treating
acute pain in non terminal patients. Consequently, many physicians and pain specialists have shied away from opioid treatment,
causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.
The problem was exacerbated when the media began reporting that the popular narcotic
pain medication OxyContin was finding its way to the black market for illicit drugs, resulting in an outbreak of related crime,
overdoses, and deaths. Though many of those reports proved to be exaggerated or unfounded, critics in Congress and the Department
of Justice scolded the U.S.Drug Enforcement Administration for the alleged pervasiveness of OxyContin abuse.
The DEA responded with an aggressive plan to eradicate the illegal use or "diversion"
of OxyContin. The plan uses familiar law enforcement methods from the War on Drugs, such as aggressive undercover investigation,
asset forfeiture, and informers. The DEA's painkiller campaign has cast a chill over the doctor-patient candor necessary for
successful treatment. It has resulted in the pursuit and prosecution of well-meaning doctors. It has also scared many doctors
out of pain management altogether, and likely persuaded others not to enter it, thus worsening the already widespread problem
of underrated untreated chronic pain.
There is nothing new under the sun. Scientific
American’s 1993 article on the harm done.