While the peak of the opioid epidemic may now have been reached (according to some), we are not out of the woods. Every decision to start or continue opioid therapy must be careful, deliberate, and weigh benefit against risk, while keeping in mind that risk is not constant/static, but dynamic and evolves through time.
With what we now know about opioid misuse and abuse, we need to take the necessary steps to ensure that only abuse-resistant/deterrent medications are used for our patients taking ER/LA opioid medications.
The TIRF REMS Access program is designed to streamline the prescribing process and ensure appropriate patients are safely provided with TIRF products, but it may be preventing patients from accessing needed medications.
The push to provide better pain care and ensure adequate analgesia for patients living with chronic pain led to liberalized opioid prescription practices that have been accompanied by a massive increase in the abuse, misuse, and diversion of prescription opioids. Efforts to combat this include technological remedies such as “abuse-deterrent” formulations of opioids and educational approaches such as the REMS program approved by the FDA in 2012.
The Canadian government’s recent decision to allow the sale of a generic version of the original formulation of OxyContin could have serious consequences for efforts to curb opioid abuse, misuse, and diversion in the US.
Steve Gelfand, MD, secretary of Physicians for Responsible Opioid Prescribing (PROP) responds to recent comments by Drs. Cole and Webster in Pain Management.