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Take on the Overall Impact of the Opioid Crisis, Scientists Urge the FDA

National Academies report urges a much more systematic approach

Here’s some real-world evidence for you. The opioid addiction epidemic, the worst drug crisis in U.S. history, is a societal problem, and not simply a medical one. Its affect on schools, communities, families—the very fabric of our lives—needs to be examined and addressed, a panel of scientists told the FDA.

This was one of the conclusions released in a report by the National Academies of Sciences, Engineering, and Medicine. According to the Associated Press, the scientists urged the FDA to look at the real-world impact of the drug crisis.

The opioid crisis is itself interlocked with the heroin crisis. When the prescription opioids become too expensive or providers stop the flow, the victims (and yes, we will use the word victim here) turn to heroin—much cheaper and easier to get in many areas.

The panel cites what the FDA did this month when, thanks to the agency’s urging, Endo International PLC, the makers of Opana ER, pulled that opioid off the market because the risks of taking it outweighed and benefits.

Aaron Kesselheim, MD, of Harvard Medical School, a member of the committee, tells the AP: “Our recommendation is for a much more systematic approach, integrating public health decision-making into all aspects of opioid review and approval. It would be an ambitious undertaking.”

This take-no-prisoners drug crisis has gotten attention because, unlike many other drug crises, it touches every corner of the country, blurring “the formerly distinct social boundary between use of prescribed opioids and use of heroin and other illegally manufactured ones.”

The report says that “it’s possible to stem the crisis without denying opioids to patients whose doctors prescribe them responsibly. But long-term use of opioids by people with chronic pain should be discouraged because it increases dangers of overdose and addiction.”

The report also recommends:

  • Encouraging health insurers to pay for pain control that includes nonopioid treatment. “The report doesn’t specify which treatments insurers should cover, but does outline what early evidence exists for acupuncture, physical therapy, cognitive-behavioral therapy, and mindfulness meditation, calling them ‘powerful tools,’” the AP reports.
  • Giving victims easier access to treatments, including drugs that fight opioid addiction, such as buprenorphine. That means making the drugs available in hospitals, prisons, and treatment programs, for a start.
  • Make it easier for people to return unused opioids. If they’re out there, they may get into vulnerable hands. The report cites a program by Walgreens, which has installed kiosks where pills can be discarded.

Sources: Associated Press; July 13, 2017; full report; July 13, 2017.

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