Ortenzio, a 35-year-old family practitioner in Clarksburg, West Virginia, reached for a box of extra-strength Vicodin. The box contained 20 pills, wrapped in foil. Each pill combined 750 milligrams of acetaminophen, the active ingredient in Tylenol, with 7.5 milligrams of hydrocodone, an opioid painkiller.
Ortenzio routinely saw patients long after normal office hours ended. Attempting to keep up with the workload on this day, he had grown weary and was suffering from a tension headache; he needed something to keep him going. He unwrapped a pill, a sample left by a drug-company sales rep, certain that no one would ever know he’d taken it. Ortenzio popped the pill in his mouth.