How a 5-sentence letter helped fuel the opioid addiction crisis

Close to 200,000 Americans have died by overdosing on prescription painkillers, and a new report traces some of the blame to five simple sentences written nearly 40 years ago.

The sentences, containing just 101 words, appeared in a 1980 issue of the New England Journal of Medicine. They formed a letter to the editor that described a rudimentary analysis of 11,822 hospital patients who took a narcotic painkiller at least once. The vast majority of those patients tolerated the drugs without incident, according to Jane Porter and Dr. Hershel Jick of the Boston Collaborative Drug Surveillance Program.

“There were only four cases of reasonably well documented addiction in patients who had no history of addiction,” Porter and Jick reported. “The addiction was considered major in only one instance.”

In their view, the takeaway was clear: “We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”

That conclusion turned out to be wrong.

Between 1999 and 2015, millions of Americans became addicted to opioid painkillers and more than 183,000 died as a result of taking the prescription drugs. According to the Centers for Disease Control and Prevention, up to 25% of patients who get an opioid prescription to treat noncancer pain wind up struggling with addiction.

“The crisis arose in part because physicians were told that the risk of addiction was low when opioids were prescribed for chronic pain,” according to the authors of a new letter to the editors of the New England Journal of Medicine. The 1980 letter was “widely invoked in support of this claim,” even though the five sentences contained virtually “no evidence” to back it up.

READ ---  Bible online dating parts - Free chat rooms no registration - Free online dating wiki - Microfinance Monitor

The authors of the 2017 letter — led by Pamela T.M. Leung of the University of Toronto — conducted a bibliometric analysis to determine how many times the 1980 letter was cited by other scholars. The answer: 608 times up through March 30, 2017.

If that number strikes you as high, that’s because it is. Leung and her colleagues also counted the citations for 11 other letters to the editor that were published within four weeks of Porter and Jick’s letter. The median number of citations for those other letters was 11.