> In 2000, Congress declared the next ten years the “Decade of Pain Control and Research,” after the Supreme Court, rejecting the idea of physician-assisted suicide as a constitutional right, recommended improvements in palliative care. Pain was declared “the fifth vital sign” (alongside blood pressure, pulse rate, respiratory rate, and temperature), and the numerical scoring of pain became a standard feature of U.S. medical records, billing codes, and best-practice guides.

This is one of the reasons that I find the push to solely blame physicians and pharma for the opioid epidemic misleading. In the early 2000's treatment of pain was being pushed, and it was deemed the "fifth vital sign", even though it is subjective unlike the other four vital signs. Physicians were being evaluated on how their patients said they treated pain. Given this environment, it is no surprise that pharma developed powerful drugs to target pain, and physicians prescribed these drugs in large amounts. We are today dealing with the fallout of this push.