Pill mills notoriously maxed out count and dosage (per script) ratios. A single Rx could be for a jar of the highest dosage.¹ This was common. Scripts written

Pill mills notoriously maxed out count and dosage (per script) ratios. A single Rx could be for a jar of the highest dosage.¹ This was common. Scripts written outside of pill mills were orders of magnitude lower in dosage and quantity. Lumping these very different numbers together paints a simplistic view of a complex issue. > Between 1991 and 2011 painkiller prescriptions in the U.S. tripled Years that include the rise/fall of pill mills. > as of 2016 more than 289 million prescriptions 289M is a single broad number representing complex and distinct things. To determine opioid use trend, some of the things we need to know are count per Rx, dosage, med type and treatment type. Institution (eg:ALF,hospice,VA) trends are distinct from public-facing doctors but we don't even look at them. We just lump their Rx #s into the pot. An important number we don't have: Denial counts for reasonable need. Single-figure opioid views don't leave us room to consider it. Chronic pain patients (who responsibly used pain relief for years) started getting shut out before 2016. That trend ratcheted one way. Their choice was losing what productivity they had or seeking illegal+risky options.¹ But as ever, the public and news orgs are much more interested in billionaires than vulnerable people in need. ¹These are things I personally witnessed.