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Teachable Moment
September 2016

Access to Prescription Opioids—Primum Non NocereA Teachable Moment

Author Affiliations
  • 1Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, Massachusetts
  • 2Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
  • 3Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California
  • 4RAND Corporation, Santa Monica, California
JAMA Intern Med. 2016;176(9):1251-1252. doi:10.1001/jamainternmed.2016.3926

A 14-year-old boy found acetaminophen-hydrocodone in his parents’ medicine cabinet and took it out of curiosity. He liked how the pills made him feel and progressed to daily use of prescription opioids. At age 15 years, he was prescribed a short course of acetaminophen-oxycodone for a back injury due to wrestling. After the prescription ended, he continued to seek prescription opioids from illicit sources, taking them almost daily. He was briefly sent to juvenile detention after being caught selling opioids. For the next 3 years he abstained from opioids but drank alcohol socially and smoked cigarettes. At age 19 years, he tried heroin with a friend and began using the drug daily. Today, he describes the experience as “spiritual… when I took the drug, it felt like I had found a deep calling.” He began selling heroin to fund his habit.

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