In the late 1980s and early 1990s, it was argued “largely on moral grounds” that opioids should be available for chronic pain. The management model that was adopted was based on the success of opioids for acute and end-of-life pain: a “titrate-to-effect” principle was applied, and a numerical rating became the chief metric. Pain came to be known as the “fifth vital sign” that the pharmaceutical industry exploited to promote narcotic use. We thus caused a man-made opioid epidemic. This report pleads for the FDA to regulate the pharmaceutical industry's ability to promote narcotics and related drugs.
Newly released data show that the epidemic has reached crisis levels. Deschutes County is below the national average. Lake County is leading Oregon and Lane, Wheeler, Grant, Curry, Josephine and Jackson counties are also above average.