THE PAIN PARADOX

If he had remained on prescription painkillers for much longer, Anthony Newberry was fairly certain he would have taken his life. It had been about 15 months since a giant metal bar fell at the construction site where he was working and crushed his foot, nearly severing his toes. Newberry, 38, of Millington, Ill., had been taking opioids for months to relieve the pain, with improperly healed nerves making it feel as if his foot and leg were "a pack of firecrackers, all day everyday. Just like someone lighting one every day, every second." Opioids helped to mask the pain, but he didn't feel like himself on the drugs and couldn't regain his commercial driver's license while medicated. One night, in a moment of desperation, he dumped the pills in the toilet and promised he'd find another way to return to his normal life. Heroin and prescription painkiller abuse kills tens of thousands of Americans each year and ensnares many more in crippling addiction. The tragic phenomenon corresponds with -- and to an alarming degree, arises from -- an epidemic of pain that affects millions, driving them to seek relief at hospital emergency departments and primary care clinics. Now, health care providers are confronting the intertwined epidemics by working to break their own long-entrenched proclivity toward prescribing opioids to treat their patients' pain.