The Challenges of Prescribing Opioids: Finding a Balance

Food and Drug Administration (FDA) commissioner Scott Gottlieb recently issued a statement calling for substantive and common-sense reforms to prescription opioid dispensation in the medical profession. The statement came on the same day the agency hosted a Patient-Focused Drug Development meeting to assess the plight of those adult and chronic pain patients, and to identify the obstacles they face when seeking opioid analgesics. Gottlieb was also careful to reassure prescription opioid users that they will have adequate access to these drugs, even while measures are being taken to prevent abuse. The agency emphasized the need to strike a balance between access to medication and rational prescribing practices in hospitals and physicians’ offices.

Gottlieb conceded some degree of over-prescribing of opioid analgesia – one in three Americans were given prescription painkillers from their doctors in 2015, according to the Substance Abuse and Mental Health Services Administration. He went on to say that opioids should generally only be prescribed for acute pain and for short durations, but left room for the possibility some patients may benefit from these drugs over longer periods. Gottlieb also discussed the fear of stigma of addiction that many chronic pain patients face and their struggle to find physicians willing to work with them.

Gottlieb’s message took great pains to appeal to prevention advocates and chronic pain patients, many of whom have come to rely on these medications to function in their everyday lives. Some of the reforms he discussed include innovative development of medical devices for pain management, creating a new series of guidance documents aimed at promoting the development of new drugs, and taking new steps to encourage medical professional societies to develop evidence-based guidelines on appropriate prescribing of opioids for different medical diagnoses.