This post strikes a very resonant chord with me since I've not only seen the ravages of opioid addiction among fellow veterans, but have some personal experience with these pain killers (emphasis on "killers").
I learned recently that I am on some sort of federal watch list of opioid-dependent veterans, have been for the last two years or so, and will be forever. Names are apparently never removed from this list despite the fact that I no longer take any pain killers, whether prescription or over-the-counter.
So how did this happen? A year ago yesterday, March 13th 2018, I had hip-replacement surgery at the VA Medical Center in West Los Angeles. What I didn't know even before the surgery was that I was already on that list because my VA Primary Care Physician had put me on a "mild" pain killer called Tramadol for arthritis pain (an opioid).
After the surgery, I was put on Oxycodone (brand name: Oxycontin). While Tramadol was described to me a "light" opioid with little chance of addiction if used as prescribed, that proved not to be the case. I later learned that the U.S. Drug Enforcement Administration (DEA) listed Tramadol as a schedule IV controlled substance in 2014 due to "high risk for addiction, dependence and overdose. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol".
But what I didn't know about Tramadol, I'd certainly heard about "Oxy", enough to be afraid of it when it was given to me after surgery. I chose to "do it right" after the hip-replacement surgery an elected to rehab in the hospital's physical therapy unit, which proved to be a very positive experience working with physical therapists, occupational therapists (which has nothing to do with "workplace") and a wonderful staff of doctors and nurses.
But with the Oxycontin, the unit's lead doctor and I agreed to limit my dosage to a maximum 30 mg per day - 10 mg three times a day. I only learned later that Oxy was being administered to other veterans pretty much "on demand", some taking as much as 100 mg per day. I've subsequently learned that addiction at that dosage can occur in as little as five days.
The VA is a bit schizophrenic about opioids, almost freely dispensing them while a patient is hospitalized, then cutting off the post-op supply a week or so after discharge. But it doesn't take much imagination to see how some patients can become addicted and dependent after hospitalization and seek other sources. Many apparently have turned to heroin that is actually cheaper and more readily available.
In my case, despite a total hip dislocation a few weeks after the surgery (incredibly painful), I weaned myself off all pain killers and feel fortunate to have no lingering consequences. But I believe that Big Pharma has successfully campaigned the entire medical profession, not just the VA, to treat "pain management" during short-term hospitalization while downplaying long-term outcomes.
Hopefully that is beginning to change.
But I will be on that list for the rest of my life.