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.
Pharma has long marketed opioids in ways that contribute to opioid use disorder and deaths by overdose. Regulatory mistakes in approving and labeling new analgesics by the FDA didn’t make us safer.
Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision making with persons with substance use disorders.