In response to the increasing use of opioid painkillers to treat chronic pain, and the alarming rise in opioid addiction, the National Institutes of Health (NIH) recently convened a panel to examine the efficacy of pain treatment in the U.S. The panel released its findings on Monday.
Opioid addiction, which includes dependence on prescription pain medication as well as heroin, has devastated communities across the United States for more than a decade. Over the last 15 years, more than 175,000 people have died from an opioid-related overdose, and drug overdose is the leading cause of injury death in the country.
The rise in overdose deaths is paralleled by an increase in painkiller prescribing. According to the National Institute on Drug Abuse, 76 million opioid prescriptions were written in 1999; that figure had risen sharply to 207 million by 2013. While addiction experts have long pointed to overprescribing as a root cause of the health crisis, pain patient advocates highlighted the need to ensure that the estimated 100 million Americans impacted by chronic pain continue to have access to care for their condition.
The report that the NIH released this week details a deep concern that opioids are common treatment for chronic pain despite a lack of studies on their long-term effectiveness and safety, coupled with well-documented potential adverse outcomes—including physical dependence and overdose. Dr. David B. Reuben, panel chair and Professor of Medicine at the David Geffen School of Medicine at the University of California, put it, “We have inadequate knowledge about treating various types of pain and how to balance effectiveness with potential harms. We also have a dysfunctional health care delivery system that promotes the easiest rather than the best approach to addressing pain.”
The panel concluded that chronic pain needs to be treated in an individualized, patient-centered method, rather than the more generalized approach currently employed. Dr. Reuben noted, “The challenge is to identify the conditions for which opioid use is most appropriate, the alternatives for those who are unlikely to benefit from opioids, and the best approach to ensuring that every patient’s individual needs are met by a patient-centered health care system.” The panel also emphasized that there is a need for more research on pain, including multidisciplinary pain interventions, the long-term effectiveness and safety of opioids, and optimal management and risk mitigation strategies.
In addition to lacking data about opioid use, a slow federal response to the alarming rate of opioid-related deaths has contributed to the problem’s growth, Phoenix House Chief Medical Officer Andrew Kolodny, M.D. told TIME. The second annual FED UP! Rally in September drove that message home when thousands of people from across the nation marched to the White House to demand federal action to the opioid addiction epidemic.