To the Editor: 

I am really pleased to see Dr. Jane Ballantyne's editorial “Repairing a Fractured Dream.”1I have a very personal perspective on the issue of pain and its treatment because my son was addicted to OxyContin (Purdue Pharma, Stamford, CT) and died of an overdose of oxycodone and cocaine in 2006.

After my son's death, I realized how OxyContin especially, but also other potent prescription drugs, had become drugs of choice for many young people. They saw them as safe because doctors prescribed them. Most young people obtain the drugs from friends, who in turn get them from medicine cabinets, relatives, or doctors who, for example, would dispense large amounts for back pain. I have come to many of the same conclusions as has Dr. Ballantyne, simply by reading, talking to, and corresponding with other grieving parents and family members and learning of the vast amounts of opioids prescribed for many different conditions. Frequently I hear from friends and others about the supply of narcotic analgesics given to them after surgery. The amounts prescribed would last for weeks but are often not needed after 3–4 days.

The devastation caused by opioids affects not only susceptible people who may have a family history of addiction, but so many others who become dependent on, or addicted to, a drug prescribed to treat pain. We should be more careful. There is a presumption that opioids used to treat pain do not cause addiction, but that is simply not true.

It is encouraging that Dr. Ballantyne acknowledges the concerns with opioid treatment in general and chronic noncancer pain in particular. My hope is that physicians and others who prescribe opioids will think carefully about the need for these medications and the amount to be prescribed.

Ballantyne JC: Pain medicine: Repairing a fractured dream. ANESTHESIOLOGY 2011; 114:243–6