By Ed Coghlan
A study published in the prestigious New England Journal of Medicine concludes people who use prescription opioids for nonmedical reasons is rare, and the transition to heroin use appears to occur at a low rate.
The study, published on January 14, emphasizes the nonmedical use of prescription opioids is a strong risk factor for heroin use.
The study is co-authored by Wilson M. Compton, M.D., M.P.E., who is Deputy Director of the NIH’s National Institute of Drug Abuse, Christopher M. Jones, Pharm.D., M.P.H., of HHS and the CDC’s Grant T. Baldwin, Ph.D., M.P.H.
“Although some authors (of other studies) suggest that there is an association between policy-driven reductions in the availability of prescription opioids and increases in the rates of heroin use, the timing of these shifts, many of which began before policies were robustly implemented, makes a causal link unlikely,” they write in their conclusion.
The report says that in 2014, a total of 10.3 million persons reported using prescription opioids non-medically – meaning they were using medications that were not prescribed for them or were taken only for the experience or feeling that they caused.
Pain Patient Advocates have been concerned over the past year about how this debate on the use of opioids – much of it fueled by two federal agencies – has focused on the nation’s serous addiction problem but has overlooked the role opioids play in helping chronic pain patients manage their lives.
“This is positive news for people with chronic pain who use their medication responsibly,” said Paul Gileno, founder and President of the U.S. Pain Foundation. “As the federal government, especially the CDC and DEA read this study, we trust that they will conclude that the discussion about addiction is extremely important and needed but equally important is the discussion of how we can best treat the person with pain.”
A recent 60 Minutes segment on linkage between using opioids leading to heroin was the catalyst for a series of articles on the National Pain Report about the topic.
The Centers for Disease Control also ignited a strong debate on the topic when it drafted its 2016 Guideline for Opioid Prescribing for Chronic Pain without input from the chronic pain community. That pressured the agency to open up a public comment period which closed last week (January 13). Some 4,000 comments were issued. The CDC will meet again on January 28 to discuss next steps.
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