It disturbs me to read that some patients are being denied opioids for severe pain.

I’m a retired pharmacist who faced the opposite situation 35 years ago, when cancer patients screamed in pain because of the presumption that they might become addicted if their opioid doses were increased.

In the early 1980s, research indicated there was no maximum dose for morphine and other opioids. At that time, hospital pharmacists were advocates for sensible pain control; we shared research results to medical and nursing staffs. As a result, perceptions concerning treatment of severe pain changed significantly, and terminal patients died peacefully following the intravenous administration of opioid medication. Similar pain control measures became common for post-operative patients and those with chronic pain unresponsive to other medications.

The major reason for the current opioid problem lies with Purdue Pharmaceuticals, which poured millions of dollars into a campaign to convince physicians that time-release Oxycontin was not addictive because the dose was absorbed over a period of time. Physicians began to believe the all-out campaign by Purdue, however, and soon Oxycontin was being over-prescribed. Purdue actually knew that their non-addictive promotion was wrong, but they pushed ahead anyway.

It would be a serious disservice to our patient population if Purdue not only started the opioid crisis, but also prevented patients from receiving the medication they require for control of their pain. I realize physicians are being exposed to increased scrutiny by government agencies, but government guidelines for pain control are not written in stone. Forty years of successful pain management should not be overturned by responding to the opioid epidemic too far in the restrictive direction.


Bruce Bartrug


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