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NIH’s Collins: Opioids Often Not Answer for Chronic Pain

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By Bara VaidaSeptember 12, 2017
From the WebMD Archives

Drug overdose deaths escalated in 2016, as the nation has struggled with one of the worse public health crises in U.S. history – the opioid epidemic. Last year about 64,000 died from a drug overdose, that is bigger than the number of people killed in car accidents, according to the CDC.

Researchers are working on solutions to the epidemic, including scientists funded by the National Institutes of Health.  Francis Collins, MD, PhD, director of the NIH, spoke with WebMD about those efforts.

WebMD: What is the number one thing you can do to stop the opioid epidemic?

 Collins: Develop non-addictive potent pain medicines that would make opioids no longer the drug of choice for the treatment of severe pain.

WebMD: What is the future of pain management?

Collins: We need to come up with alternative interventions that are effective, but not addictive. There are at least a half dozen such therapeutic ideas that are somewhere in the pipeline, some of them already that are in phase II trials [Phase II trials determine if a drug is effective.]. But it’s been moving a bit slowly because of uncertainty about whether or not there was a welcoming [business] market for such pain medicines and also because the tendency has been for those to be viewed as having [to have] no acceptable side effects and that is pretty hard to achieve. Now with this crisis, I think the dynamic has changed and there is potential here to accelerate bringing some of those ideas across the finish line and getting them approved. Then people who have legitimate pain, which is 25 million people in the U.S. who have pain every day, would have an alternative that actually works and [doesn’t make] them addicted.

WebMD: So options like non-addictive medication and behavioral methods for pain management?

Collins: Behavioral as well, yes, because we understand that can have a big impact. All of those modifications, we need to put our foot down on the accelerator and go.

 WebMD: Is there any way to avoid addiction when it comes to management of pain specifically?

Collins: There are alternatives. They aren’t as potent as opioids, but frankly we are now learning that if you have chronic pain, opioids aren’t really going to help you in the long run. They may make things worse, in terms of severity of your pain. It is the wrong approach. So if someone has chronic pain that’s not from cancer, it’s better to stay away from opioids. They won’t be the answer that you are looking for…. That said, there are some indications in which opioid use may be necessary, so it will be important in those circumstances to closely monitor patients for potential overdose and addiction risks. One of the things that I worry about, is that we don’t have, not in this country anyway, enough access to pain experts who run clinics where people can find out about other options for pain. It’s pretty hard to find a series of health care providers that see that as their mission.

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