The narrative seems to be that over the course of a couple decades we let pharmaceutical companies promote the heck out of their pain pills and encouraged the doctors to hand out narcotic pain-relievers like harmless candy and thus our society irresponsibly got zillions of people hooked on opiates and now they’re shooting heroin.
That sure doesn’t mesh with my recollection of the 1990s and 2000s. WTF?
I trained as an LPN in the early 1980s, when the attitude had shifted away somewhat from “pain is often just in people’s head, don’t prescribe narcotics unless they really need it” and was now “pain is always real, there’s no such thing as imaginary pain; when your patient is in pain they deserve relief from it”. But by the beginning of the 1990s I was hearing from people from a wide and varied segment of society (including my own parents) that there was a crackdown going on, that doctors were now afraid to prescribe narcotic pain medication lest they be accused of supporting addicts’ habits. People told me they had gone in for operations and been sent home without a prescription for anything stronger than Motrin unless they requested it. When you did get a prescription it was for a more limited supply and no refills, and you’d have to come in in person if you needed more.
Situations in which, in the late 1970s and early 1980s, would have resulted in a prescription for codeine were now being addressed with Tylenol 3. Go in with a painful sore throat and instead of an automatic turpin hydrate with codeine prescription in the big brown bottle, you’d get a recommendation to try chloraseptic or cepacol, and only if that didn’t do the trick would you get a grudging scrip for hycodin in a much smaller bottle (and, again, no refills).
Glossy magazine ads and commercials on television touted the wonders of prescription medications for high blood pressure, high cholesterol, erectile dysfunction, depression, memory deficits, hyperactive bladder, etc, with the “ask your doctor” tagline, but I don’t recall one single ad for hydrocodone or oxycodone or fentanyl or dilaudid.
Was I unduly influenced by my nursing instructors so that I saw puritanical disapproval of pain relief when actually prescription pain meds were being dispensed willy-nilly left and right? How did I manage to formulate an impression that seems diametrically opposite to what we’re now being told was the trend over the last 20 years?