"Beginning in the late 1990s, pharmaceutical companies selling high-dose opioids seized upon a notion, based on flimsy scientific evidence, that regardless of the length of treatment, patients would not become addicted to opioids...How did we get this so wrong?"
~Dr. David A. Kessler, former head of the Food and Drug Administration, "The Opioid Epidemic We Failed to Foresee", the New York Times (May 6, 2016)
Because he ran the FDA from 1990 to 1997, Dr. David Kessler can speak with authority and insight when it comes to certain problems existent in America today. And when it comes to what the Centers for Disease Control and Prevention has labeled an "epidemic" - the explosion of opioid over-prescribing and the resultant overdose deaths - Dr. Kessler doesn't hold back.
Speaking to CBS News recently, Dr. Kessler called the opioid situation in the United States "one of the great mistakes of modern medicine", and said there is plenty of blame to go around.
"FDA has responsibility, the pharmaceutical companies have responsibility, physicians have responsibility. We didn't see these drugs for what they truly are...The inappropriate promotion of drugs contributed significantly to this epidemic. Because drug companies took a small piece, a sliver of science and widely promoted it as not being addictive. That was false."
According to numbers released by the CDC, the number of drug overdose deaths is rising at an alarming rate. Take a look at the most recent statistics:
Dr. Kessler believes that it is going to take a concerted effort by everyone involved, saying, "Everybody has to do better. The CDC guidelines need to be implemented. Pharmaceutical companies need not over-promote. Doctors need to prescribe more wisely in a more limited way. But it's going to take a societal shift, it's bigger than any one of those steps, in order to change this epidemic."
The guidelines that he alludes to were just released by this past March. For the first time ever, the CDC is recommending that physicians:
The idea is NOT to turn a blind eye to a patient suffering chronic pain. Rather, the goal is to focus on other effective methods that do not carry the same risks of dependency, misuse, addiction, and overdose.
Just within the past few years, many communities across the country have implemented patient databases that physicians and pharmacists can access as a way of preventing patients from "doctor-shopping" in order to obtain multiple prescriptions.
Ultimately, there is a degree of responsibility that must also fall upon patients and their families. This is the "societal shift" that Dr. Kessler referred to. It is in the best interest of anyone seeking pain relief to educate themselves about the real risks of prescription opioid painkillers. When a doctor - in good faith - writes a prescription for opioid medication, the well-informed patient needs to proactively ask about alternatives.
When opioids are prescribed, both the patient and their loved ones need to be acutely aware of the effects of the medication and be especially watchful for any signs of drug diversion.
Here's the bottom line -the general consensus in the medical community now is that opioid medications are not always appropriate for every patient in pain. More importantly, if you or someone you care about is misusing a prescription opioid painkiller, it is absolutely imperative that the assistance of a trained addiction specialist is sought as soon as possible.