The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested.
Note that the rate of opioid prescription in the US had dropped by nearly 50% since 2012 [1], while the overdose rate has more than doubled [2]][3]. Meanwhile the same crackdown that has led to a huge decline in prescriptions has also led to a decrease in the amount prescribed, to the extent that there is strong evidence it is harming patients because doctors are so afraid of losing their license they are unwilling to prescribe the correct therapeutic dose to patients.
A study in JAMA recently found that when doctors reduce the dosage of pain medication prescribed to long term opioid therapy, it leads to a threefold increase in suicide attempts and a 69% increase in overdoses[4]. In other words, the federal guidelines adopted to try and ensure that the drug was less readily available from doctors and prescribed in smaller doses seems likely to have cost a significant number of lives.
There don't seem to be easy answers, and the driving forces behind (and possible solutions to) the massive increase in overdose deaths in the US remain elusive. But at a minimum a simple model of "it's caused by doctors giving people prescriptions for painkillers" seems to not be supported by evidence at this time.
> The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested.
No, it really isn't. US doctors were massively over-prescribing very strong opioids and telling patients that these were not addictive.
This meant that communities were flooded with clean, pure, strong, opioids. This supply was legal. The fact that it subsequently got diverted into the misuse supply chain doesn't alter the known facts of the opioid crisis - that there was massive over-supply of legal meds.
Note that the rate of opioid prescription in the US had dropped by nearly 50% since 2012 [1], while the overdose rate has more than doubled [2]][3]. Meanwhile the same crackdown that has led to a huge decline in prescriptions has also led to a decrease in the amount prescribed, to the extent that there is strong evidence it is harming patients because doctors are so afraid of losing their license they are unwilling to prescribe the correct therapeutic dose to patients.
A study in JAMA recently found that when doctors reduce the dosage of pain medication prescribed to long term opioid therapy, it leads to a threefold increase in suicide attempts and a 69% increase in overdoses[4]. In other words, the federal guidelines adopted to try and ensure that the drug was less readily available from doctors and prescribed in smaller doses seems likely to have cost a significant number of lives.
There don't seem to be easy answers, and the driving forces behind (and possible solutions to) the massive increase in overdose deaths in the US remain elusive. But at a minimum a simple model of "it's caused by doctors giving people prescriptions for painkillers" seems to not be supported by evidence at this time.
[1]: https://www.cdc.gov/drugoverdose/rxrate-maps/index.html
[2]: https://www.drugabuse.gov/drug-topics/trends-statistics/over...
[3]: https://apnews.com/article/overdose-deaths-record-covid-pand...
[4]: https://jamanetwork.com/journals/jama/fullarticle/2782643?gu...