Last week’s Consumer Reports cover story, “Special report: The dangers of painkillers” highlights the important issue of prescription pain drug abuse in our country. However, they missed the mark on several important points that will now just add to the existing confusion and misinformation in any real attempts to solve the prescription drug epidemic.
The article underscored the health risks surrounding overexposure of acetaminophen, but failed to acknowledge that, unlike other hydrocodone products, Zohydro ER is the only hydrocodone product that does not contain additional active medications, the most common of which is in fact acetaminophen. This important differentiating factor makes Zohydro ER an important, safer treatment option for patients with severe chronic pain who can no longer tolerate or have a medical contraindication to acetaminophen (or combined ibuprofen) yet are doing well on hydrocodone, some of whom have no other opioids options due to poor response or intolerability.
Their article also overestimates the role of abuse deterrent technology (ADT) in preventing prescription drug abuse. While it is part of the solution, it is not the ONLY solution nor is it the best.[1,2] More importantly, if it were the panacea, insurance and other third party payers are not willing to pay for opioids with ADT, leaving only the more affordable generic (non-ADT) opioids as an option – so a world with only ADT products would inherently discriminate against the poorest underserved opioid-requiring patient populations, likely the very same population that is at higher risk of opioid abuse. We must use a comprehensive approach that does include ADT, but also sensible legislative policies, prescriber and patient education, tools and resources like locking prescription bottle caps. The key is to stop opioids from getting into the wrong hands, not deny access to those who have a legitimate need for them.
Sadly, Consumer Reports continues a pattern followed by many in the media of whipping up fear over the dangers of opioids without also providing balance by considering the benefits that these important drugs have for patients who use them appropriately. This has unfortunately had an adverse effect on legitimate pain patients and has served to fuel anger in those unfortunate families who remain to grieve over a loved one that has succumbed to opioid addiction, eventual overdose and death. The media has been grossly irresponsible (as addressed in multiple of my blog posts categorized here) by ignoring the whole truth, and [educated] politicians should be ashamed for using the misfortune and grieving of others to bolster a bully pulpit by which to gain popularity while hanging their legitimate pain patient constituents out to dry.
As always, comments are welcome and encouraged!
- Twillman R, Fudin J. Potential Cost-Shifting And Hidden Costs And Risks In The Economic Analysis Of Opioid Abuse Deterrent Formulations. Pain Medicine. 2014. doi: 10.1111/pme.12489
- Kirson N, Shei A, White A, et al. Societal economic benefits associated with an extended-release opioid with abuse-deterrent technology in the U.S. Pain Med. doi: 10.1111/pme.12489.