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There is good news and bad news when it comes to the nation’s decade-long opioid/heroin addiction epidemic. The good news is the government has cracked down on pill mills,  strengthened warnings on pill labels and approved an injectable form of naloxone which reverses heroin overdoses and will reduce deaths in the hands of caregivers and police.

The bad news is on the same day the FDA announced plans to tighten restrictions on hydrocodone combination products like Vicodin, it approved the long-acting drug Zohydro made from hydrocodone bitartrate which has five to 10 times the abuse potential of the infamous OxyContin. The FDA did so over the objections of many medical and public health groups and its own advisory committee. And even as public health professionals are outraged by the FDA’s tin ear and refusal to learn from the opioid addiction epidemic, a pill that combines oxycodone with morphine is also inching its way toward approval.

Many of the current addicts started out on narcotic painkillers and turned to cheaper and more available heroin when their supply became cut off or got too expensive. This risky switch from pills to street drugs was abetted by the creation of a “deterrent-proof” version of OxyContin that people could no longer crush and snort. (The reason OxyContin had been king on the street was all 80 milligrams could be ingested at once if the pill was crushed, a rush described by users as better than cocaine.)

But why were millions of Americans on narcotic painkillers, once limited to terminal and cancer pain, surgery and accidents, to begin with? Because Big Pharma paid doctors in advisory positions to institute looser guidelines, reports the Milwaukee Wisconsin Journal-Sentinel – and quickly discovered that the medical establishment and patients neither remembered or cared why narcotic painkillers had been the most restricted of all drugs.