It would be a mistake to infer from the snippet you’ve posted that I’m in any way denying the association between access to and subsequent abuse of prescription pain meds. Manifestly, if the abused substance of choice is only a drug that can be obtained by prescription alone then, by definition, a prescription is the source (legally obtained or not). You don’t need to do a tremendous amount of reading around the topic to see that the addiction/overdose epidemic is a little more complex.
To your links…
I discounted your BMJ article as a worthwhile source. This was an opinion piece, basically and the apparently damning statement implying that whilst some surgeons prescribed opioid pain meds judiciously (presumably Makary’s team?) others send their patients home with a swag of weeks and weeks worth of highly addictive stuff. No way to check whether this was fact or opinion as the paywall kicked in.
The JAMA study doesn’t really tell us much that we dont know now in 2022 based as it was on data mined over a period 20 or so years ago…and with many of the references that either predate the study period or were opinion pieces in non peer publications. I didn’t have the stamina to wade through it to confirm an already established fact that excess prescriptions can be tracked closely.
Your press release…although it was a press release and subject to the usual issue of the banner headlines not quite representing what the study actually tells us. This ended up being an interesting read …the primary document, that is. The actual movie…not the report based on the trailer. Here’s the link…
https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.121.055524
I guess there are a number of ways to interpret any study and this is as good an example of any. Now, it might be me misreading your statement here, but it looks on first blush as if you’re confusing the authors’ use of persistent opioid use (POU) with the opioid addiction problem…and that might very well be the authors’ opening statement because that’s how it looks. Initially.
Now, this was a new term to me (POU)…but per the authors’ definition, this term meant a second prescription within 30 or so days of their first post op prescription and not a descent into a life of addiction. These data were obtained from a prescription database, BTW, not patients’ survey (always iffy) so likely a true representation. Here’s the thing, though…they also appear to have standardised the different prescriptions for dosage by something called oral morphine equivalent (OME) and, unless my math is dodgy, the two prescriptions combined were a bit less than the orthopod gave me as ostensibly a one time only script. Blimey, if I’d have asked for the top up meds I really needed I would’ve been considered a persistent opioid user. So, without any understanding of the need WRT the procedures and follow-up care, this doesn’t look to me to be a major contributor to the opioid epidemic but rather an example of judicious prescription of opioids.
Another interesting feature of this study is that there are hyperlinks to other articles. One statement that was a eye opener is that, prior to the increase in use of opioids in the 1990s, the US was already using 80% of the World’s opioid production. Still got more to plow through so I thank you for the edutainment.