The Challenge of Balancing Pain Management and Addiction
Treating pain is an important part of medicine, but it also requires a delicate balance against the risks of patient addiction. The most commonly used medications for relieving moderate, severe, and chronic pain are opioids, and these are highly addictive. Millions of people have fallen victim to one or more of these drugs, and it is not only the pain patient at risk. Friends and family members with access to a patient’s pain medications may abuse them or sell them to others.
The Problem of Prescription Painkiller Abuse
Opioid painkiller abuse, addiction, and overdose have been growing problems over the last two decades. From 1992 to 2002, the number of Americans abusing these drugs tripled. Over the next 10 years, the number more than doubled and continues to grow. More people are addicted to painkillers than any other drug. Overdoses blamed on prescription painkillers have tripled over the last 20 years.
While so many people are abusing, getting hooked on and even dying because of these drugs, there are millions of others who genuinely need them to relieve serious pain. Living with chronic and serious pain is not acceptable for anyone, but neither is the large death toll caused by painkillers. The challenge for lawmakers, physicians and advocacy groups is to strike a balance.
The Role of Prescribers
Many have put blame for the epidemic of painkiller abuse on the shoulders of prescribing physicians. No one group is solely to blame, but doctors have been known to overprescribe opioids, often giving them to patients who don’t truly need them. The Food and Drug Administration (FDA), which has made opioid abuse and addiction its number one priority, has encouraged education among physicians as to how and when to appropriately prescribe opioid painkillers. Manufacturers of these drugs are now required to provide training for doctors to help them prescribe more appropriately and monitor patients using painkillers.
The Role of Drug Makers
The FDA has attempted to make painkillers safer by regulating the way in which drug manufacturers make, label and sell their products. One product that has contributed greatly to opioid addiction is the extended release pill. This is a formulation that allows a patient with chronic pain to take one pill a day and get round-the-clock relief in small doses. Abusers quickly learned to crush the pill in order to get the higher dose all at once. The FDA now requires that these types of pills include strongly worded labels warning about the risks of overdose and addiction if misused.
The Role of Law Makers
Legislators and policy makers also need to play a role in curbing the trend in opioid abuse and addiction. Experts recommend that states set up databases to track patients receiving prescriptions for opioid painkillers, for instance. These would prevent the type of doctor shopping that people have engaged in to get multiple prescriptions. Policy makers, including the FDA, can also control factors such as how drug manufacturers make their drugs. For example, they can require that all extended release formulas include crush-proof technology that prevents abuse.
The balance between managing pain for millions of Americans and preventing abuse and addiction is a delicate one. Many people are involved in this issue and it requires the efforts of all to make sure that patients are treated appropriately while addiction and overdoses are minimized. It is important to also remember that patients have a role to play. When pain patients are better educated about the risks of using opioids, even more instances of abuse could be avoided.
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