Monday, April 6, 2020
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To The Presidential Commission On The Opioid Crisis: Here Are Some Suggestions From An MD

President Trump recently established a commission to address the opioid crisis, considered by many people to be the most pressing public health concern in America.

This issue is urgent, complex and emotional for many people. Members of the presidential panel should dedicate themselves to being informed by and grounded in the evidence about pain and about opioids. They must seek insights from clinicians and other experts who are on the front line of this epidemic. Also, they have to listen closely as patients and their family members share their often-devastating experiences with opioids.

Photo credit: Virginia Mason Medical Center

The commission also must evaluate the potential benefits of alternative options to treat pain and support returning to optimal function. A barrier to wider use of alternative therapies is they are not consistently covered by insurance plans. One of the panel’s goals should be to align incentives that will encourage evidence-based best practices for managing pain.

Chronic and acute pain affects at least 100 million American adults and costs society as much as $635 billion annually, according to the Institute of Medicine report, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research.” The report also states that pain management is “a moral imperative” for our nation and health care professionals.

Opioid pain relievers can be safe when taken for a short time and as prescribed by a doctor. Unfortunately, opioids are frequently overused and misused (taken in a different way or in a greater quantity than prescribed, or taken without a doctor’s prescription). For some people opioids can produce euphoria in addition to pain relief, the National Institute on Drug Abuse explains. Regular use, even as prescribed by a doctor, can result in dependence, and when misused or abused, opioid pain relievers can lead to fatal overdose.

Let’s hope the commission is committed to fact-finding and partnering with stakeholders in developing answers to difficult questions. Quality of life for millions of Americans is at stake.

About the writer: Donna Smith, MD, is executive medical director at Virginia Mason in Seattle.


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