DANNY BARCELONA LIVES IN constant fear that doctors will stop the medications he considers lifesaving. The 66-year-old has suffered for more than two decades with a debilitating nervous-system disorder and severe back and shoulder pain, forcing him to close his once-thriving dental-lab business in Asheville, North Carolina, and sometimes leaving him bedridden for 18 hours a day. That he can function at all, he says, is due to his ongoing prescription for oxycodone, an opioid.
In the middle of an epidemic of opioid overdoses, doctors, hospitals and pharmacies across America are facing intense pressure to sharply cut back on prescribing and dispensing the drugs. About 8 million patients in the U.S. who depend on opioids to face constant, intense pain are at risk of losing access to the one treatment that seems to make the pain bearable. That includes Barcelona. “I don’t think I could have lived without the drugs I’ve been taking,” he says.
The number of opioid prescriptions has plummeted from a high of 251 million in 2010 to well under half that number in 2020—the last year for which figures are available from the U.S. Centers for Disease Control and Prevention (CDC). Yet the number of opioid overdoses has only continued to climb, even as drugs such as buprenorphine that can help overcome addiction and slash the risk of overdose are becoming harder to access than opioids themselves.
The twin problems of patients with a legitimate medical need losing access to opioids, while the addiction and overdose rates swell, add up to a new opioid crisis that may be worse than the original one that emerged at the turn of millennium. Federal and state governments, along with health care, bungled the response to that original crisis, say a range of experts.
As a result, patients and the addicted are caught between the pincers of prescription cutbacks and increasingly difficult-to-access options for dealing with addiction. “Pain was poorly treated in America up through the 1980s before we started paying attention to it,” says Keith Humphreys, a psychiatry professor at Stanford University and a drug policy adviser in the Bush and Obama White Houses. “Today we’re still failing.”
Skyrocketing Overdoses
THE NATIONAL INSTITUTES OF HEALTH RECKONS that more than
