Manufacturers of prescription opioids offered assurance in the mid-to-late 1990s that these drugs wouldn’t make patients with pain into patients with substance use disorders. Some physicians believed them and prescribed these drugs without appropriate regard for their addictiveness, contributing to prescription and street opioid misuse that has reached alarming proportions. This issue considers ethical questions that contextualize the opioid epidemic from social, cultural, and policy-based perspectives and illuminates potential solutions.
Pain is the most common reason patients seek health care. The AMA Pain Care Task Force suggests how clinicians can offer good pain care and become savvy about situating themselves in the health care system to do so.
AMA J Ethics. 2020;22(8):E709-717. doi:
This third era of opioids ruining thousands of US lives follows a first era of iatrogenic addiction stemming from the Harrison Act of 1914, and a second was marked by changes in pain treatment attitudes between 1950 and 1970.
AMA J Ethics. 2020;22(8):E729-734. doi:
Dr Travis Rieder discusses his own experiences with opioids and the ethical challenges of “legacy patients,” and Dr Stephanie Zaza, president of the American College of Preventive Medicine, discusses the future of opioid research priorities.
Should physicians unilaterally taper opioid doses for patients whose doses are high because of past physicians’ aggressive prescribing?
Which forms does stigma take against people with substance use disorder (SUD)?