There is an impressively comprehensive article written on the Huffington Post website titled The War Over Prescription Painkillers by Radley Balko. Worth a read because it’s well-researched and very clear if you’re wondering how and why the situation with respect to such a massive patient population has gotten this way.
He’s also done a good job of explaining how the painkiller issue ties into Chronic Pain as a medical issue:
The Problem of Chronic Pain
Chronic pain is different from short-term or end-of-life pain. It can persist for years, even after the associated injury or condition has gone away. For some patients it can be burdensome, for others it can be debilitating. Chronic pain can also cause depression, anxiety, sleep disorders, and affect decision-making. Because pain is more of a symptom than a disease, it can’t really be diagnosed, so it’s difficult to come up with a precise number of people affected. But in 1999, the Society for Neuroscience estimated that as many as 100 million Americans will suffer from some sort of chronic pain. The National Center for Health Statistics puts the number closer to 75 million.
Despite the recent headlines about the rise in sales of prescription painkillers, chronic pain is still significantly under-treated in America. There are a number of reasons why. For one, there’s no diagnostic test to diagnose pain, so doctors must rely on patient descriptions of what they’re feeling. That can be tricky, because tolerance for pain varies widely from person to person. Culturally, pain has also long been viewed as something we encounter and endure as part of the human condition. In many religions, noble suffering is considered pious. Pain treatment is also a relatively new medical specialty; it didn’t have its own medical society until the early 1980s.
But the biggest barrier to effective pain treatment continues to be bad public policy, much of it driven by the war on drugs. Opioids — morphine, oxycodone, methadone, and other drugs derived from the opium plant (or synthetically structured to mimic it) — are the most effective way to treat severe and chronic pain. Emerging (but still controversial) treatments like long-term, high-dose opioid therapy have shown particular promise with chronic pain. Just this month, an article in the journal Science described another promising new therapy, in which large doses of the drugs delivered over a short period of time, shortly after an injury, may help prevent chronic pain from developing at all.
But it’s also true that opioids can be abused. The potential for abuse has attached to opioids a social and cultural stigma that can make doctors reluctant to prescribe them, and patients reluctant to take them, even in end-of-life care. But pain patients and their advocates say the bigger problem is that drug control has taken priority over ensuring access to effective treatment. To be sure, there is a divide in the medical community over the effectiveness of long-term, high-dose therapy. But what ought to be a research-driven debate among medical professionals has been corrupted by policies aimed at preventing addicts and drug pushers from obtaining painkillers, not what’s in the best interest of pain patients. Police and prosecutors now dictate medical policy.