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For more than two thousand years, physicians have known that opium and its derivatives bind tightly—not only to receptors in the human body, but to lives. The knowledge is ancient; the pattern is predictable. Yet in the United States over the past two decades, patients were inducted into dependence by the medical system and, too often, expelled from it when risk and scrutiny rose. The treatment ended; the need did not. That gap—created by prescribers, payers, and policies—became a bridge to the illicit market, where potency and adulteration turned dependence into sudden death. This episode is about that bridge, the moral failure that built it, and the practical steps to tear it down.
By Niklas S Osterman BHPRN, MA
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