Government officials and political parties slog on in dull debates about how to spend more or less on Medicare and Medicaid, but the basic arguments about why and how to limit pain medicines seems to have been completely dropped from recent writers’ minds.

It has always seemed obvious to me that pain medicines should be easier to get in small to moderate quantities — but who knows the basic economic mis-incentive argument that people will pay far more for pain medicines than the chemicals cost to produce?

Medical doctors make sure they get a cut of that possible extra money by requiring a lot of often-useless expensive office visits, and drug companies try to keep out cheaper alternatives. Their basic argument is that, if not limited, people will overindulge and so must be limited in their purchases to prevent addiction (scientifically defined as requiring more and more to get the same result). Also, to prevent people from using pain medicines to cover up more serious conditions they should see a doctor about and to prevent people from overworking or exhausting themselves.

But the existing system of FDA drug approvals has been described as increasingly political. Often-deadly oxycodone is more available than cheaper morphine (which I have seen the best drug for an epileptic), and is easily bought or stolen in Florida, then kills people in West Virginia.

John Pettengill, MIT ECON Ph.D., Lewiston

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