Hydrocodone was most prescribed drug in America in 2011.
In a recent newspaper article, a Nebraska State Patrol investigator called the abuse of prescription drugs an “epidemic” in the state.
Aly Hassan, M.D., assistant professor of psychiatry in the University of Nebraska Medical Center College of Medicine, agrees. “Clinically, it’s a very common problem,” Dr. Hassan said.
But why now? Why is this happening at this moment in time?
Part of it, Dr. Hassan said, is that we’re treating pain differently than we did even not so long ago.
“Remember, the ‘90s was the decade of treatment of pain,” Dr. Hassan said. There was a shift in medicine, a change in policy. “An important aspect of that was to consider pain as the fifth vital sign.” The four primary vital signs are body temperature, pulse rate, blood pressure, and respiratory rate.
You’ll see it often in doctors’ offices and clinics: signs on the wall which urge you to rank your discomfort from 1-10.
And there’s good reason for that, Dr. Hassan said. It’s not that people are not as tough as they used to be. Pain is a serious thing, and should be treated seriously.
“The experience of pain is not only somatic. It’s not just the nerve being stimulated,” Dr. Hassan said. Acute pain can affect not just quality of life, but quality of health. You can even see it in a person’s vital signs.
“When you solve acute pain, all that normalizes,” Dr. Hassan said.
It’s no wonder the medical field was starting to emphasize the treatment of pain.
But with that came all of these drugs.
In 2011, hydrocodone was the most prescribed drug in America, according to WebMD.
At first, many in the medical community were not worried about drug addiction. If someone is given a pill while in pain, when the pain goes away they’ll stop taking it, right?
“The pain patient can be treated with narcotics with little risk of developing the self-destructive behavior characteristic of addiction,” concluded a 1990 report “The Use of Narcotics for the Treatment of Chronic Pain,” by the Sacramento-El Dorado Medical Society.
But, Dr. Hassan noted in 2012, the makeup of many of these drugs are compatible with addiction in that they absorb very fast, and the half-life of the medicine staying in the system goes very fast. And then patients want another.
“The opiates are very addictive for that reason,” Dr. Hassan said.
Physicians are in a tough spot. That doesn’t absolve them of responsibility.
But, “This is beyond the level of an individual practitioner,” Dr. Hassan said. “This is really a state problem or even a national problem.”