Friday Feedback: The Continuing Problem of Opioids and Pain
An FDA advisory committee will meet next week to discuss the FDA's use of Risk Evaluation and Mitigation Strategies (REMS) to prevent diversion and abuse of opioid painkillers. The FDA, concerned about rising overdose deaths from prescription opioids, is considering more restrictive REMS features such as mandatory physician education and certification, and a wider range of opioid products to be covered.
Robert B. Goldberg, DO, executive dean, Touro College of Osteopathic Medicine in New York City: The volume of prescribed opioid drugs shot up a few years ago. The increase was not explained by the number of cancer survivors, or by any increase in accidental injuries. Increased prescribing does track with a change in policy toward physician's consideration of pain. We can measure blood pressure, pulse, temperature and heart rate using sophisticated devices that demonstrate incredible interexaminer reliability. After that we present a card to the patient with pictures to record pain, a.k.a. the fifth vital sign. The efforts to add pain as the fifth vital sign was supported by the pharmaceutical industry. Add to that the move to rate the "medical visit experience," with surveys, there is no wonder that prescription volume climbed.