Abuse deterrent Opiates: Are they worth the extra cost?

shutterstock_184172777Dozens of SERMO physicians are discussing opiate use inside SERMO’s Pain Medicine Hub, based on a conversation started by one of our physician contributors.  What do you think about this article written by a Pain Medicine specialist on SERMO?

Millions of people suffer from chronic pain in the US. Opiates are the an important treatment for the treatment of chronic pain. By some estimates, close to 5 million people are prescribed opiates every year. Over the last 10 years, there has been a significant increase in Opiate prescriptions. This is  because of a few reasons:

– JCAHO guidelines making the “pain” fifth vital sign

– Different state boards like California recommending the clinicians be aggressive with evaluation and treatment of both acute and chronic pain

– Around this same time, increased cardiovascular events with chronic use of NSAIDs led to boxed warnings and guidelines for cautious use of NSAIDs.

All of these things led to increased use of Opiates.  Consequently, this led to the current epidemic of prescription drug abuse among recreational users that in turn led to thousands of prescription drug overdose deaths at an alarming rate among women and youth.

As a result, there is increased scrutiny of prescribers. Many state and federal agencies are trying to impose restrictions in the form of dose ceiling, pill count restrictions, and many others. FDA asked the pharmaceutical industry to develop formulations that are abuse deterrent and mitigate the abuse problem among recreational users. FDA has developed draft guidance for the pharmaceutical industry to develop abuse deterrent technologies and formulations for opiates and may allow the companies to carry a label to that effect if their formulation and products meet certain criteria. These formulations could play an important role in curbing opiate misuse and abuse and may become standard of care and become part of the comprehensive strategy for safe opiate prescribing opiates safely.

Are abuse deterrent opiates worth the extra cost?

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