Lost amidst the news of more opioid deaths and the ongoing legal troubles of Purdue Pharma is another terrifying side to the story. As a psychiatrist specializing in addiction, witnessing people fight the demons of opioid addiction is frightening, but even more so is the number of uneducated physicians who prescribe life-threatening medications–virtually without a second thought–to patients with a history of substance abuse. I know. I was one of those–one of countless practitioners who wished we had known better.

Yes, it was a different time and place. We practiced what had been taught. When I finished my psychiatric training in 1995, the world of addiction medicine and psychiatry was a much smaller universe. Yet to be fully understood were the million little pieces needed to put the puzzle of a patient’s history together to form a proper diagnosis and best course of treatment. Prescriptions were the panacea.

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