NO EASY ANSWER TO OPIOID ADDICTION EPIDEMIC
By Join Together Staff | November 13, 2013
There are no easy answers to solving the opioid addiction epidemic, according to experts at the American Association for the Treatment of Opioid Dependence annual meeting this week. Thomas McLellan, CEO of the Treatment Research Institute, told NBC Philadelphia a multi-faceted approach is needed.
“You don’t have any alternatives [to opioids]. The only alternative is a non-steroidal anti-inflammatory; well it’s got liver toxicity and it’s not all that potent. There’s nothing between that and a very powerful opioid,” said Dr. McLellan, who served as the Deputy Director of the White House Office of National Drug Control Policy. “This is one of those problems that society has to manage. You can’t do away with it. Not with 70 million older Americans who vote and are aging and need them. You can’t ban them.”
Doctors don’t have proper training to understand opioid addiction, Dr. McLellan noted. “They prescribe too much. They don’t manage them. About 70 percent of all the overdose deaths occur within 48 hours after the first prescription or after the first refill,” he said.
He and Dr. Jeannemarie Perrone, Director of Toxicology in the Hospital of the University of Pennsylvania’s Emergency Medicine Department, recommend that doctors follow national guidelines from the American Academy of Pain Management. These guidelines recommend that patients sign a usage contract, and submit to an annual toxicology screening test to confirm they are taking the medicine and not taking other drugs before the doctor issues a prescription.
Patients also need to be part of the solution to opioid abuse, Dr. McLellan says. “It has to be the joint responsibility of the patients to take medication as prescribed. Don’t give them to your sister, don’t leave them in your medicine cabinet, don’t take more than you need,” he added.
The FDA recently voted in favor of pushing a new formulation of oxycodone hydrochloride for approval. The new OxyContin formula is more difficult to crush or dissolve which will hopefully make it harder to be used as a drug of abuse . The FDA recommended that Purdue Pharma's application for a new, resin-coated formulation should replace the original version, which has been on the market since 1996. Randall Flick, MD, an anesthesiologist at the Mayo Clinic who voted to recommend approval of the drug said, "Clearly the old formulation is worse than the new, although I think the difference is relatively small," Flick concluded, "Hardcore abusers are likely to devise new ways to break down the harder tablet or figure out which solvents will dissolve it fastest, within 'day or weeks' of the product's release on the market."