We ought to have learned by now that blanket prohibitions are never very effective when it comes to drugs. And trying to put hydrocodone off limits now is like trying to force the genie back into the bottle.
There's a cocktail of forces that brought us to this epidemic level: clueless doctors, reckless patients, highly potent medication, and the difficulty inherent in trying to assess someone else's pain.
Science may be headed to the rescue: A pharmaceutical company is working on developing non-addicting opioids. And research into the "neural signature" of pain suggests that doctors may soon be able to measure physical discomfort by scanning images of our brains.
We are early in this journey; it's only been in the last few decades that we've recognized pain as an ailment worthy of treating medically.
So it's troubling to hear good doctors say that the frenzy over patient deaths is making them leery of treating pain.
I spoke with one who stopped treating pain management patients and shut down his medical practice. "One death, one complaint … and your reputation is ruined," he said.
Now he's a medical school professor, teaching new doctors how to judge the motives of their patients: Check the state's prescription database, require prior medical records, screen their urine, and don't be afraid to touch them.
"You want to believe your patients. But people are dying, and physicians need to own this," he said. "Are these potentially dangerous drugs? Of course. But patients suffer if fear takes hold."