Pain Management and the Opioid Epidemic
Millions of Americans experience acute and/or chronic painful conditions each year, many of whom are prescribed opioids to help them manage their pain. While the vast majority of people who are prescribed opioids do not misuse or intend to misuse these drugs, like illicit opioids such as heroin, prescription opioids trigger biochemical processes in the brain that can be experienced as pleasurable and rewarding beyond the effect of pain relief. Because of these rewarding properties, opioids pose a risk of addiction to pain patients and, often at no fault of those to whom they are prescribed, make their way into the hands of people for whom they were not intended, including illicit markets. The risks associated with use of prescription opioids (addiction, overdose) and the consequences of these for families, health care and social service providers, and others therefore manifest not only among pain patients but at a broader societal level.
Balancing the appropriate use of opioids in the context of the often sub-optimal clinical management of pain, in the fragmented health care delivery system of the United States, is a complex endeavor. Pain Management and the Opioid Epidemic explores incorporating public health considerations into regulatory decisions for opioids, while preserving appropriate access for those individuals who will most benefit from their use. This report provides a framework that will enable a more circumspect approach to regulatory decisions for opioids.