Narcotic Addiction & Abuse

The excessive prescription of narcotics has led to an epidemic of abuse and addiction in America, leading the FDA to, belatedly, place limitations on the amount of hydrocodone that a patient can receive between office visits and to require written (rather than phoned-in) prescriptions to obtain them.

Having practiced Internal Medicine for 36 years, primarily as a hospitalist, I have long observed the overuse of these addictive medications and place the blame squarely on physicians.  While these medications are designed primarily for acute pain relief following infection, injury or surgery, patients are too often sent home with a month's supply of the narcotic, sometimes with a refill or two; in the majority of cases, the patient could have been managed with a few days of the narcotic, transitioned to ibuprofen, naproxen or acetaminophen in combination with physical therapy.  The extended availability of narcotics leads to their overuse and, within a relatively short period of time, to dependence.

While patients with certain malignancies, neuropathies and other painful conditions might need long term narcotic therapy, most patients who use narcotics on a chronic basis are addicted to those medications; since, over time, they develop tolerance, the dose must be gradually increased.  In the end, the excessive amount of these drugs in medicine cabinets across the country, in combination with black market sources, has led to their abuse by teens and young adults; combined with alcohol, sedatives and other illicit drugs, narcotics have become a leading cause of overdose-related deaths in otherwise healthy individuals.