There's a street demand for these prescription drugs, whether obtained from pharmacy theft, unethical doctors, or addicts who fake their pain to get legitimate prescriptions. And that means that it's become more complicated to get an opioid prescription, even for patients in real need.
The rise of prescription narcotic abuse
Prescription-narcotic misuse began to climb in the mid-1990s, fueled in part by oxycodone (the active ingredient in OxyContin and other drugs). Traditionally, opioids had been prescribed mostly by oncologists and pain doctors. But OxyContin was marketed by its makers, Purdue Pharma, to physicians as being less prone to abuse and less likely to cause addiction. (The company and three executives pleaded guilty in May 2007 to overselling the drug's safety and were fined more than $630 million.)
Although OxyContin had been designed as a slow-release drug, it was soon known that it could be crushed and snorted, giving a heroin-like high. Abuse became epidemic in some areas.
But as the New York Times Magazine pointed out in a 2007 article, the uptick in arrests and investigations into the diversion of controlled substances (which include opioids), coupled with a lack of adequate training in pain management, can be a deterrent for legitimate prescribers. They may be fearful that investigationseven those that don't result in chargescould cost them their livelihoods. In 2007 the DEA arrested 82 doctors for crimes related to the diversion of controlled substances, and opened cases into 896.