The number of deaths in the United States due to prescription opioid use has exceeded 16000 per year. This is more than the number of cocaine and heroin overdose deaths combined.1,2 A significant complexity of this epidemic is that many opioid users do not recognize that they may have a problem with drug use because they “only take what my doctor gives me.” Nonetheless, many of these patients have a formal opioid use disorder.3 For many of these patients, there is a cycle of use and withdrawal that the patient perceives as pain, a cycle that is only relieved upon ingestion of opioids. Ultimately, the patient is in pain most of the time because he or she cannot obtain, ingest, or endure the needed doses of drug to stave off withdrawal. The patient may become focused solely on obtaining opioids, and he or she will go to any length to obtain their narcotics.
Daniel Saal. Rewriting the Script. JAMA. 2015;313(23):2323–2324. doi:10.1001/jama.2015.2653