FDA mulls prescription painkiller problem

A pharmacist fills prescriptions in Leesburg, Florida. The FDA is trying to balance the needs of pain sufferers and the dangers of addiction in evaluating its guidelines for prescription painkillers. (Photo: Charles W Luzier)
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Trish Anderton

The Food and Drug Administration is opening up discussion on a longstanding and difficult issue: how to ease chronic pain while minimizing addiction to painkillers.

The agency is collecting public comments online and at a two-day meeting in February. It’s particularly seeking “scientific evidence, such as study data or peer-reviewed analyses, on issues pertaining to the  use of opioid drugs in the treatment of chronic pain.”

Some of the questions it’s weighing are: should there be a maximum daily dose for addictive painkillers? Should that dose vary depending on the disease? Should there be a limit on how many days or months a patient can be prescribed a particular drug? How do doctors define “mild,” “moderate” and “severe” pain, and how would changes to the labeling of addictive painkillers affect the way doctors dispense them?

The meeting will be held February 7-8 in Bethesda, Maryland.  The agency is collecting comments at regulations.gov through April 8.

As the Washington Post recently reported, an increase in the use of prescription painkillers over the last two decades has helped fuel a raging addiction problem. Nearly two million Americans are now hooked on painkillers -- more than are addicted to heroin or cocaine.

On the other hand, GIMBY’s The Backyard Fence reported in June that pain sufferers feel efforts to clamp down on prescription drug abuse have hampered them from getting the relief they need.

The comments submitted so far on regulations.gov illustrate the difficulties of that divide. Five pain sufferers write to plead for access to medications.

“I take low doses of oxycodone and sometimes, hydracodone, and am able to go to classes, lectures, exercise classes and have a little social life,” comments Abot Bensussen. Without my pain pills, I'd still be bedridden with no quality of life at all. Please consider people like myself when discussing the pain community.”

But two people weigh in about the devastation caused by prescription drug addiction. Ken B Cairns describes himself as an addiction medicine MD. “I have listened thousands of hours to many hundreds of those suffering opioid addiction and also people with chronic pain,” he writes. “I will tell you i have learned beyond a doubt that opioid addiction and the pain of opioid addiction are much worse than any chronic pain condition.”

How do you think the FDA should balance the needs of pain sufferers against the risk of addiction? Go to regulations.gov to read and comment on the proposal -- and don’t forget to share your comments below!