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The prescription opioid addiction and abuse epidemic: how it happened and what we can do about it


I am UK pharmacist living in the USA and have worked with patients suffering with pelvic, abdominal and related pain for many years. In 2013 FDA, in response to a citizen petition, considered restricting the labeling language for immediate-release preparations. Although they have subsequently declined to implement these proposals, the issue lead to a great deal of debate and comment by medical and patient advocacy organizations. My organization, the International Adhesions Society ( conducted a survey in collaboration wiht a number of other patient groups to assess the impact of the proposals on the accessibility of legitimate pain patients to analgesics. We submitted our comments to FDA, which included recommendations that would tackle this problem in the context of a wider national pain policy as follows: (see for full document) "Any program addressing opioid abuse and misuse must be understood within the wider context of a nation al strategy on pain prevention, treatment, management, and research...... This strategy must include the following elements: • Promotion of R&D of safer pharmaceutical and non-pharmaceutical alternatives to opioids. • An expedited FDA approval program for these alternatives. • An expedited Medicare reimbursement approval program for these alternatives. • A review of policies to ensure that modalities such as physical and psycho-therapy are adequately reimbursed to ensure effective pain relief. • Promotion of education about pain and its relief for student and graduate medical practitioners. The [Institute of Medicine] report noted that an average of only 11 hours of training was offered in medical schools on this subject. Curricula must include the proper use of non-opioid analgesics and alternative modalities. Physicians need to fully understand how to use opioids and to counsel patients in their safe use. • The facilitation of implementation by professional medical organizations of practice guidelines about how alternatives should be used before opioids are prescribed. • Recommendations as to funding these activities given the enormity of the task. • Time and volume targets for the wider deployment of opioid alternatives. " Although some of these recommendations are specific to the USA, they can be adapted for other countries such as the UK. We have conducted our own research on a wearable therapeutic ultrasound device for the treatment of pain (PainShield MD) and have found that patients reduce their need for opioid and other analgesics. We established a company - KevMed, LLC ( to market this device. One of the problems we are having is that at present in the US this device is not reimbursed. In the UK there is no reimbursement for the device. If we are to be serious about tackling opioid abuse, health authorities need to review their policies about paying for devices or alternative therapies that could reduce the need for opioids. See also our press release regarding this issue. Sincerely David Wiseman PhD MRPharmS President KevMed, LLC founder International Adhesions Society

Posted date

30 JUL 2015

Posted time



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