Potential strategies to combat the opioid crisis

ABSTRACT

Introduction: In the last few decades, the consumption of opioid analgesics in many countries, particularly the US, has dramatically increased. This rise has been paralleled by a proportional number of opioid-related deaths.

Areas covered: The development of opioid guidelines was a response to this health crisis with the intention of reducing the risk of harm related to opioid prescribing. These guidelines have received varying responses ranging from support to criticism. Pain physicians may often provide multidimensional management as the paradigm for responsible opioid treatment. Interventions should focus on preventing new cases of opioid addiction, identifying early cases of opioid addiction, and ensuring access to effective addiction treatment.

Expert opinion: Many activities have been suggested to face the opioid epidemic. Reducing supply is one of the most relevant aspects. Clinicians should find a fine balance that meets the patient’s need for pain relief while minimizing the chance for abuse.

KEYWORDS:

• Non-cancer pain
• opioid epidemic
• misuse
• overdose

Article highlights

• The rise in opioid consumption has been paralleled by a proportional number of opioid-related deaths.

• Several opioid guidelines have been developed as a response to this health crisis with the intent to reduce the risk of harm related to opioid prescribing.

• A better education program among physicians and new generation of students regarding chronic pain management may be helpful.

• Prevention measure have a prominent role: primary prevention is aimed at reducing the incidence of a disease or condition

• For the secondary prevention, it is necessary to identify and treat opioid-addicted individuals early to reduce the risk of overdose, psychosocial deterioration, transition to injection opioid use, and medical complications

• For the tertiary prevention, the goal is to prevent medical complications, psychosocial deterioration, transition to injection drug use, or the development of injection-related infectious diseases, and overdose deaths.

This box summarizes the key points contained in the article.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A peer reviewer of this manuscript declares receiving consultancy fees from the opioid manufacturer Nektar Therapeutics. The peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.