The FDA recently decided to tighten the labeling requirements for opioid medications.  Over the past decade, opioid medications have become increasingly prescribed for pain conditions.  Unfortunately, these medications have also become highly abused in the US.  From multiple fronts, there has been a push to control the use of opioids and improve their safety.

A Brief History of Opioids

Opioids are strong analgesic medications used for a variety of pain control situations.  Initially, they were used to treat short-term, acute pain related to surgery, injury, and illness.  Eventually, opioids also became a pain relief option for terminal illnesses such as cancer.  As pain became a concern in quality of life, and considered a “fifth” vital sign, opioid medication prescriptions blossomed.  As opioid popularity increased, opioid prescription abuse also swelled.  Now both the FDA and DEA are working to stem abuse and improve the appropriateness of prescribing by physicians.

Opioid Abuse and Pain Management

Pain is extremely challenging to manage and treat.  The complexity of pain has spawned it’s own medical specialty – Pain Management. Twenty years ago, finding a physician who knew anything about pain management was a rarity.  Currently, there are some pain specialists, but still very few board certified specialists in the US.  Medical school training programs still do not have formal pain education, and most medical residencies have no pain medicine training or experience at all.  Pain fellowships train only a small number of physicians yearly.

Pain management is complex, requiring specialized knowledge, and the ability to find a variety of solutions for difficult problems.  Opioid medications have been easy to prescribe and often a simple solution to a variety of pain problems. The FDA is trying to change the wave of opioid use through changing the labeling of medications, warning physicians and patients that these drugs may be dangerous.  Unfortunately, this is likely to be an overly simplistic solution to a complex problem.

A Better Solution to Opioid Abuse

Improving opioid prescribing is important, but the better starting point may be improving the understanding of pain by doctors as well as patients.  Doctors need more training, starting in medical school and progressing throughout residency and practice.  Patients would also benefit from the help of physicians trained and specializing in pain medicine.  Pain is complex and opioids are only a small part of a solution.  It will take multiple efforts to decrease opioid abuse, and improve appropriate prescribing. The FDA is starting the effort, but it will require concerted effort by doctors and the medical community to increase knowledge of opioid use and its potential dangers.