In the 1990s opioid pain medications were promoted as safe, well tolerated and very effective at controlling pain. During this time physicians started significantly increasing the number of prescriptions for opioids. Also, during the late 1990s and early 2000s there was a push by regulatory agencies and the public to strive for achieving near zero pain in patients with pain, both acute and chronic pain. There were law suits against physicians and at least one physician lost a civil suit for elder abuse for under treating a cancer patient with pain. He was ordered to pay $1.5 million to the patient's children.
At the same time hospitals accreditation companies had the PAIN SCALE added as an additional vital sign. Anesthesiologist and other physicians were being forced to increase pain control and this resulted in more opioid prescriptions at higher doses. At the same time some drug companies, like Purdue Pharma, continued to promote opioids as safe and effective. Sales of oxycodone and hydrocodone soared. Read "Data Shows many companies contributed to US opioid crisis"
The predictable consequence of striving for 0/10 pain (complete pain relief) in all patients was to have over doses. This was just the case. The brakes were then put on as everyone realized that PAIN CONTROL not PAIN RELIEF should be the goal. Of course many patients would have pain relief.
Now in the 2010s in West Hills as well as across the USA, we realized that all that prescribing has caused some patients to become addicted to prescription opioids and this led to increase used of heroin and organized crime being involved in selling of prescription pain medications. Read "More than 1 million OxyContin pills ended up in the hands of criminal and addicts. What the drugmaker knew" by the LA Times.
Now there are 130 people who die every day from opioid related overdoses and 11.4 million people misuse prescription opioids. As a result of this data being made public, there has been a tightening by the DEA and state governments on the prescribing of opioids by healthcare providers. New oversight, mandatory education programs, voluntary education programs and changes to the actual paper prescription formate have been put in place. Many states require mandatory safety measures and monitoring for any patient who is on their third or fourth month of prescription opioids.
HHS has a nice web page with the data regarding the magnitude of the issue.
The LA Times has done a nice piece of investigative reporting on the involvement of drug companies in the problem.