Opioid prescriptions have increased three-fold over the past two decades, and we have seen how this skyrocketing availability of medications has helped create a new drug abusing population, some of whom suffer severe health consequences. More deaths now occur as a result of overdosing on prescription opioids than from all other drug overdoses combined, including heroin and cocaine. The opioid epidemic is tied closely to another epidemic in our country, that of chronic pain—although the ties are very complex.
Abuse of prescription opioids, stimulants, and other psychotherapeutic medications presents unique challenges. On the one hand, these drugs can produce serious harm (even death) when not taken as prescribed; on the other, they are powerful clinical allies that can be life saving. Thus, the approach we take and the messages we convey to minimize harm need to be nuanced and multipronged.