HJAR Jul/Aug 2022

12 JUL / AUG 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   A “Pandora’s box” is a metaphor in our modern languages, and the proverbial phrase refers to a source of endless com- plications or trouble arising from a sin- gle, simple miscalculation. It relates to the Greek mythology connected to the myth of Pandora in Hesiod’s “Works and Days.” He reported that curiosity led Pandora to open a box, thus releasing sickness and emotional curses upon humanity; a mod- ern, more colloquial equivalent is to “open a can of worms.” 1-3 In this third installment of our series about drug addiction, we will try to revise and analyze what went wrong and how we ended up in this terrible and deadly opioid epidemic. We will also examine how we lost control and ended up with thousands of deaths due to overdose events and how we have seen increasing amounts of drugs laced with fentanyl that made these com- binations even more lethal. We will also review how the medical community has responded to try to diminish the rate of these tragic deaths that have brought sad- ness, frustration, loss of working force, boys and girls left without a father or a mother, parents without a son or a daughter, and so many more sad consequences that have been impacting American society since the whistle was blown by a heroic, persistent, and committed pharmacist in Poydras, Lou- isiana, in the early 2000s after finding out that the death of his son happened during a drug deal gone bad. 4 THE BEGINNING: OPENING PANDORA’S BOX Pain is a sensation that all of us fear, but it is also an especially important symptom of sickness — an alarm that something is not right within our bodies. The International Association for the Study of Pain (IASP) has released a newly revised definition of “pain”in 2020: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” 5 In the early 1990s, Purdue Pharma began JULIO OLAYA, MD Julio Olaya, MD, is a board-certified anesthesiologist specializing in pain medicine at Pain Medicine Specialists of Arkansas. He was an assistant professor of anesthesiology and critical care at SLU School of Medicine, pediatric anesthesiologist, director, and founder of the Pediatric Pain Service at Cardinal Glennon Children’s Medical Center in St. Louis, Missouri, from 2013 to 2015. He was an assistant professor of anesthesiology and pain medicine at the UAMS College of Medicine from 2004 to 2012. Olaya did a pediatric anesthesia fellowship at Arkansas Children’s Hospital and a fellowship in pediatric pain management at Cincinnati Children’s. He has been practicing adult pain medicine and spine intervention procedures since 2015. Originally from Mexico, he completed a medical degree from La Salle University in 1986 and was the sports medicine doctor for the Mexican Tennis Federation from 1990 to 1993. He completed an anesthesiology residency at UAMS in 2003 before joining the UAMS/ ACH faculty in 2004.