National Academies Report May Frame New Guidelines For Opioid Prescribing

A new report released by the National Academies provides a series of recommendations to federal regulators about how to address the ever-worsening opioid abuse crisis in the United States.

The consensus report on opioid prescribing was conducted by the National Academies of Science, Engineering, and Medicine (NASEM) and was launched in 2018. The focus is to help advance the development of opioids to treat acute pain for specific conditions without unnecessary prescribing, which would worsen the opioid crisis.

The U.S. Food and Drug Administration (FDA) announced the release of the new report in an statement issued December 19.

NASEM was provided a framework for the report, and was commissioned to evaluate opioid prescribing to support clinical practice guidelines, to help identify gaps in the evidence where future research is needed.

NASEM examined existing opioid prescribing guidelines and current research on opioid prescribing to help fill the gaps of knowledge concerning opioids. Additionally, NASEM held a series of meeting and public workshops which included people with expert knowledge on existing guidelines and those with new evidence.

The FDA will consider the recommendations from the report as it begins implementing the Substance Use-disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.

The agency must also address the role doctors play in addressing the crisis, since new prescriptions for opioids remain high and for durations longer than appropriate. The agency has to focus on reducing the number of unnecessary opioids while still providing access to patients who have severe pain.

For example, one-third of lupus patients are still prescribed painkillers like Vicodin or OxyContin even though medical guidelines call for lupus patients to avoid opioid painkillers.

Doctor prescribing habits have been at the forefront of the opioid abuse crisis considering many prescriptions are written inappropriately without a pain diagnosis. Doctors who are rewarded by drug companies also prescribe more painkillers.

The FDA is focusing on addressing the national opioid crisis, as opioids now account for nearly 70% of all overdose deaths.

The NASEM recommended the agency consider a variety of factors, including decreasing exposure and preventing new addiction. Recent research has indicated more than half of all patients prescribed opioids don’t need them to treat their pain. More so, excess opioids are often given after surgery when patients don’t actually need them to treat their pain.

Furthermore, the report also recommends the FDA focus on supporting addiction treatment, fostering the development of new pain treatment therapies, and taking action against those who contribute to the illegal importation and sale of opioid products.

“That’s why it’s important that we re-examine how opioid analgesics are being prescribed and help to ensure that health care providers – who are the gatekeepers to prescription opioid analgesics – are provided with the most current and comprehensive guidance on the appropriate management of pain,” wrote Dr. Janet Woodcock, Director for the Center of Drug Evaluation and Research.