“The opioid epidemic is a national crisis that should not be underestimated.” That’s a quote from a June 1st New England Journal of Medicine perspective piece by Susan Glod. She’s a physician involved with hospice and palliative care and pain management. But the title of the piece reveals another issue related to the current situation. That title is The Other Victims of the Opioid Epidemic. Those other victims being people in desperate need of pain treatment who cannot now get it because of fears related to the prescribing and use of opioids.

To try to help to avoid abuse, new forms of opioids have been created, called abuse-deterrent opioid medications. These can’t be crushed or dissolved, thus making them difficult to snort or inject. But “these formulations would have no impact on other opioid-related deaths such as unintentional overdose.”

Glod in an audio interview related to her New England Journal piece.

“I think that the downside to all of these formulations is that they have the potential to make needed medication more expensive and less accessible to patients who are having opioid responsive pain and who really do require these medications. What really worries me the most about all of this is that if the medical community, the public and policy makers get too distracted by the promise of a solution to the opioid epidemic in the guise of a reformulation of known opioids, I’m worried that we’re going to lose focus on addressing all of the underlying systemic issues that have really led to the epidemic in the first place—such as lack of access to alternative evidence-based means of controlling pain, the lack of mental health and social services to address other components of suffering besides physical pain, and the lack of providers who are trained in managing drug addiction and dependence.”

Glod’s full article and audio interview are available at the website of the New England Journal of Medicine.

—Steve Mirsky