Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use

 

Valerie Reyna

Dr. Valerie Reyna is a member of National Academies' Committee on Pain Management and Regulatory Strategies To Address Prescription Opioid Abuse.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the  science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA’s development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

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This is an important report. Both untreated pain and the epidemic of opioid use are serious problems requiring urgent solutions. Somehow the balance must be found to both manage the increasing problem of pain in the aging US population, while regulating more effectively the diversion of prescription opioids into the broader population. This report represents the best thinking about how the balance might be made more effectively, while acknowledging the social determinants of opioid diversion and use in depressed communities.

Elaine Wethington

- Professor Elaine Wethington, Professor, Department of Human Development, Department of Sociology, and Gerontology in Medicine, Weill Cornell Medicine