This is a very complex issue involving multiple factors. Some that are commonly heard are: changes in medical philosophy regarding pain, careless doctors, drug companies, the 1996 launching of OxyContin, the addictive potential of the drugs, cost, changing preferences of drug users, the lack of effective non-narcotic alternatives for pain management ... others. So, it is a mistake to point to one factor, as does The Charlotte Observer. The paper not only oversimplified the issue, but added its own agenda — blaming doctors, something that is evident from the headline of its article of May 14: 
Approximately 100 percent of readers who see this headline will automatically think, "the pills killed Riley Martin, and his doctors are to blame." Unless you bother to read the article. Then the story changes a bit: "An autopsy revealed Martin had overdosed from a toxic mix of cocaine and prescription medications, including the types of opioids obtained from his doctors." Not only is the headline misleading, but it could also be wrong. Did Riley take all of the pills? How much cocaine did he take? What were the other medicines he was taking? How much, if any, did they contribute? At first glance, the number of pills seems to be quite high. But the maximum dose of Vicodin or Percocet is 12-five milligram pills per day. Over nine days, that adds up to 108 pills — not much different than the maximum recommended dose over that time period. How much did the other legal medications contribute? Martin was also being treated for severe anxiety: "[During a previous] visit, [Martin's physician] increased Martin’s dosages for both Zoloft and Klonopin after Martin complained that he still suffered anxiety." Was this death a result of laziness or indifference by Martin's doctors? "Records show that [one of Martin's physicians] discussed pain management options and instead of prescribing Percocet as Martin requested, [he] called a prescription for 25 Vicodin to [his] pharmacy." (1) Was this death, even as tragic as it was, due to malpractice or criminal negligence by Martin's doctors? "[T]he North Carolina Medical Board and the Board found that the of care by [the physician assistant who also cared for Martin] was appropriate and fully complied with the applicable law and regulations.” Also, "Martin was not honest about his drug use. Martin listed his only medication as a nasal decongestant." I am not at all saying that Riley Martin's tragic death was his own fault, or that he in any way deserved this awful fate. That would be entirely unfair. Just like the headline. Unlike the misleading headline, this incident is very far from simple. No one knows exactly why Riley Martin died. The Charlotte Observer doesn't either. It shouldn't pretend otherwise. The paper should also hold off on assigning blame. It is possible that the only "blame" in Riley Martin's death lies with some very imperfect drugs. Note: (1) Percocet is about 1.5 to 2-times stronger than Vicodin
Josh Bloom
Director of Chemical and Pharmaceutical Science
Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.
