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America has promising new law in fight against national opioid crisis

America has promising new law in fight against national opioid crisis
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As deaths related to opioids continue to increase, one would be hard pressed to find a community or person that has not been affected in some way by this national crisis. As the epidemic rages on, finding ways to effectively navigate this public health emergency remains a challenge.

In a promising turn of events, however, President TrumpDonald John TrumpJoaquín Castro: Trump would be 'in court right now' if he weren't the president or 'privileged' Trump flubs speech location at criminal justice conference Comey reveals new details on Russia probe during House testimony MORE has signed legislation that has potential to take a high level strategic approach to fighting the opioid crisis on several fronts. The Support for Patients and Communities Act directs much needed resources to research and public health programs that aim to prevent and treat opioid use disorder. This law includes funding for grants created to combat drug addiction at the state level, the creation of comprehensive opioid recovery centers, and desperately needed regulatory guidelines for recovery housing.

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The opioid package, which overwhelmingly passed the House and Senate with bipartisan votes, recognizes that these drugs have an important medical application for the treatment and management of pain. This acknowledges a crucial concern that many in the pain management field have raised that some approaches to combating the opioid epidemic may actually be worsening the addiction problem.

Until recently, emphasis has remained on limiting prescriptions. However, there is little evidence that this approach is effective. The underlying assumption used to be that opioid prescribing practices were the principal cause of the epidemic. But while opioid prescriptions have decreased since 2012, overdose deaths have continued to increase. Prescribing practices may have been played a role in how this epidemic began, but restricting prescriptions is clearly not going to be the solution.

In reality, however, prescription limits have put people at risk of untreated pain without addressing the more common ways that people come to abuse prescription opioids, such as through illegal importation or diversion. Unfortunately, it now appears that these limits have gone too far. Instead of witnessing reduced rates of opioid use, the places hardest hit by these prescribing limitations have seen increasing rates of suicide.

There are several studies that demonstrate chronic pain patients have increased thoughts of suicide and are reported to mention suicide more frequently. The consensus in the medical community is that untreated pain frequently leads to depression and increased risk of suicide, so it follows that limiting the prescription of pain medications would result in these depressive and suicidal states. Moreover, these conditions are often driven not just by physical pain, but by the stigmatization of chronic pain.

It is therefore essential to eliminate stigma from the conversation about the opioid crisis and ensure that our policies do not place undue burden on the more than 100 million Americans who have some form of chronic pain, many of whom are appropriately prescribed opioids. While opioids are one of the most effective ways to address both acute and chronic pain, the future holds a lot of promise in the development of novel pain medications. The opioid bill signed last week recognizes this reality.

Moreover, there has also been a renewed public focus on research and development of new analgesics that are not opioids. The Food and Drug Administration is now charged with developing an expedited pathway to usher these products into the market. Under the 21st Century Cures Act, analgesics that offer significant advantages over existing drugs, including lower risks of addiction and dependence, can be put into an expedited development pathway. This work is essential to the solution because until we have better alternatives to opioids, patients will continue to need them and the risks of abuse and addiction will remain part of the problem.

Over the last several years, we have relied exclusively on reactionary, urgency driven, blame game, one size fits all approaches. Despite pouring resources into addressing the issue, these approaches have only led to a worsening of the epidemic. As we look toward a future where all patients with pain receive appropriate treatment without the risk of addiction, we need to thoughtfully consider the potential implications of our policies and programs. The Support for Patients and Communities Act marks a refreshing advance in the solid efforts to combat the opioid crisis.

Carrie Wade is director of harm reduction policy at the R Street Institute. Cory Goracke Postle is director of the Minnesota Center of Pain Research.