The dope on dope: Abuse-resistant narcotics are useful, but not a panacea

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Screen Shot 2015-05-07 at 1.58.55 PMAt ACSH, we have weighed in multiple times about our country s bizarre conglomeration of drug laws. Sometimes they make sense. Sometimes they don t. Sometimes you can t even tell.

But, it would seem the FDA is using both common sense and good science with the respect to at least getting a handle on the enormous, narcotic abuse problem (mostly oxycodone and hydrocodone) that has been plaguing the US for years.

This week , the agency issued its final guidance on the use of abuse-deterrent formulation opioids (also called opiates) to minimize the growing addiction problem of these powerful painkillers.

ACSH s Dr. Josh Bloom, who has written a number of pieces on this subject, including a Science 2.0 piece that was highly critical of a recent New York Times editorial and a New York Post op-ed that was critical of the DEA, says, Even given the pharmacological limitations in the treatment of pain, the FDA guidance is wise, and well thought out, and should help. But, even if their recommendation that opioids should be sold using abuse-deterrent technology is strictly adhered to, this will have, at best, a modest benefit.


Dr. Bloom explains, Given the spectacular advances we have seen in treating a host of medical conditions during the past century, it may seem odd that, even 117 year after the marketing of heroin supposedly a less addictive version of morphine that there is still no good way to manage severe chronic pain. Opiates are the strongest drugs, but they have a big downside, especially addiction. But, in the absence of better alternatives, these drugs are still the only option for many patients.

There are multiple components to this intractable problem, but anything that minimizes the chance of patients who need narcotics of later becoming addicted to them is a no-brainer.

Dr. Bloom says, In some cases, people who take narcotics for a period of time will start to enjoy them a little too much. This can cause them to misuse the pills, often by grinding them up and smoking and snorting the drug, greatly increasing the possibility of addiction. Preventing this misuse will certainly stop some people from falling into this pharmacological trap. It is not a perfect solution, but it makes sense on every level.

The FDA considers this matter to be a high public health priority. We could not agree more.