In 2015, 2 million people had a prescription opioid-use disorder and 591,000 suffered from a heroin-use disorder; prescription drug misuse alone cost the nation $78.5 billion in healthcare, law enforcement, and lost productivity. But while the scope of the crisis is staggering, it is not hopeless.
We understand opioid addiction better than many other drug use disorders; there are effective strategies that can be implemented right now to save lives and to prevent and treat opioid addiction. At the National Rx Drug Abuse and Heroin Summit in Atlanta last April, lawmakers and representatives from health care, law enforcement, and many private stakeholders from across the nation affirmed a strong commitment to end the crisis.
Research will be a critical component of achieving this goal. Today in the New England Journal of Medicine, we laid out a plan to accelerate research in three crucial areas: overdose reversal, addiction treatment, and pain management .
The term “silent epidemic” sometimes gets overused in medicine. But, for prescription opioid drugs, the term fits disturbingly well. In 2012, more than 259 million prescriptions were written in the United States for Vicodin, OxyContin, and other opioid painkillers. That equals one bottle of pain pills for every U.S. adult. And here’s an even more distressing statistic: in 2011, overdoses of prescription painkillers, most unintentional, claimed the lives about 17,000 Americans—46 people a day .
The issue isn’t whether opioid painkillers have a role in managing chronic pain, such as that caused by cancer or severe injuries. They do. What’s been lacking is an unbiased review of the scientific literature to examine evidence on the safety of long-term prescription opioid use and the impact of such use on patients’ pain, function, and quality of life. The NIH Office of Disease Prevention (ODP) recently convened an independent panel to conduct such a review, and what it found is eye-opening. People with chronic pain have often been lumped into a single category and treated with generalized approaches, even though very little scientific evidence exists to support this practice.