Scientific American had a great piece in the June issue by a young doctor who entered medical school in 1996. She must be a member of the generation I lost by delaying child-bearing until I was 34. My own mother was 18 when I was born. If I had followed her lead, my grandkids would be almost to middle school, instead of aspirations.

Other things about my life would be different, too.

1996 was nearly coincident with the appearance of “oxy” and other opioid-based prescriptions, and during this doctor’s seven years in medical school, it became the pain-killer of choice. She describes herself as a natural skeptic, which I think is aspirational for all of us. She did not see any reason for this significant change in practice.

The doctor envisioned a long-term, randomized, controlled trial to compare opioids with non-opioids in patients with serious chronic pain. It took years to fund, but she finally managed to run it starting in 2012, and published her results last March. Patients given non-opioids not only fared as well in terms of pain interfering with their daily lives, they also reported less pain and had fewer side effects.

Why had no one else thought to seek data before writing the Rx? Marketing.

Her opposite-of-evil twin in the dental profession, which is a huge user of opioids, created a mandatory protocol at the UMN School of Dentistry requiring NSAIDs for pain relief in most cases, with minimal-dose opioids reserved for the most difficult surgeries. In 15 months the school cut opioid prescriptions in half, with no increase in after-hours calls or return visits related to pain.

Sometimes Obvious Man is just waiting for someone to notice him.

How great it is that an individual can make such a difference. How sad it is that thousands of addicts are dying each year because clinicians bowed to their corporate overlords rather than engaging their brains.

What wrong trope is mucking about with your own life? Be a skeptic!