In the past week, two Senators questioned a planned study by the FDA on long-acting opioids. They write, “This study is intended to specifically look at the use of EERWs [enrichment enrollment randomized withdrawal] to approve new opioids.” That is not all they got wrong.
chronic pain
A recent prospective study of post-surgical patients confirms what many other studies have already shown: prescribing opioids to control pain carries a very low risk of addiction or misuse.
A record of bias and incompetence disqualifies the The Centers for Disease Control (CDC) from further roles in creating public policy for treating patients in pain.
They are the foundation of the CDC's 2016 opioid guidelines, resulting in legislation that limits opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians, since many state legislators fail to understand – and translate into policy and law – the ‘16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager to embrace them.
The CDC's 2022 revisions of the deeply flawed 2016 Prescribing Advice contains some welcome changes that should reduce the needless suffering of pain patients. Unfortunately, the new document does not go far enough. My comments will be officially submitted to the CDC during the public comment period.
The following is a compendium of articles and op-eds I have written since 2013. It is an updated version of "Analyzing The Opioid Crisis: 65 Articles By Dr. Josh Bloom," which was published in 2019.
The Veteran Administration's "Opioid Safety Initiative" – as fine an example of doublespeak as you'll see – succeeded in reducing opioid prescriptions by 64% in less than a decade. That's just fine if you're prepared to accept the accompanying 75% increase in rural veteran suicides. Drs. Jeffrey Singer and Josh Bloom are not. Here's their opinion piece in The Virginian-Pilot.
Cato Institute's Dr. Jeffrey A. Singer, also an ACSH advisor, and Dr. Josh Bloom argue in The Philadelphia Inquirer that the unwinnable war on drugs is simply a losing proposition for pain patients.
Although pain patients in the U.S. continue to struggle mightily to get the prescription opioids they need, at least they -- finally -- have the American Medical Association behind them. But in Canada, patient advocacy groups are also fighting the Canadian Medical Association, something that can be seen in an open letter to the CMA from the Chronic Pain Association of Canada. Here are some of the letter's highlights, especially those involving contributions from ACSH.
In March I wrote about Phase IIa results of a novel NSAID-like drug ATB-346 (now called otenaproxesul), which is structurally and functionally similar to naproxen (Aleve). But the non-opioid drug lacks its gastrointestinal side effects, especially ulcers. Now Phase IIb results are in and it still looks good. Will it become the first member of a novel class of pain drugs? We could sure use it. A summary of the company's report to shareholders.
When I wrote about "Magic Aleve" -- a derivative of Aleve/naproxen that appears to be both G.I.-friendly and a more potent analgesic/antiinflammatory than Aleve itself -- a number of questions arose. Dr. John Wallace, CSO of Antibe, which is developing the drug called ATB-346, kindly agreed to answer them.
There hasn't been a material advance in the pharmacological treatment of pain since the 1890s, when heroin and aspirin were invented. That may change if an experimental drug being developed by a Toronto-based drug company keeps performing in advanced clinical trials. This could be huge.