State governmental bodies and many clinicians are concerned about the increasing volume of adverse outcomes associated with use of opiates. Not since the Civil War have there been so many persons addicted to opiates or experienced terminal events. It is truly a national crisis.
Nationwide, fatalities due to accidental overdose with oxycodone is second only to fatal motor vehicle accidents as the leading cause of accidental death. In many states it is the leading cause of accidental death. The Sate of Washington will soon require patients not responding to escalating doses and strengths of opiate products to be forwarded for specialty pain management evaluations.
The FDA, clinicians and patients each have different concerns regarding these products.
• The FDA is obligated to determine the effectiveness and safety of opiate products offered to the market. It must provide recommendations to the government with the objective of creation of legal regulations concerning these products.
• Clinicians want safe, effective medications to prescribe without special training, certification, and documentation requirements for product use. Moreover, physicians wish to avoid special scrutiny or oversight regarding use of any medications.
• Patients want strong, safe analgesia, particularly without the possibility of a fatal event.
Drug companies have not yet produced opiates that are both effective and truly safe without euphoria, development of tolerance, or impairment including respiratory suppression with death. As such, they do not yet offer any solutions to these challenges.
We can only hope that much safer products are on their way. Otherwise, new legal actions will decrease the number of physicians willing and able to work with these products to address legitimate patients. In the interim, when visiting with your doctor discuss alternative and complementary medicine approaches that may lessen use of opiates, decreasing the risk of related adverse outcomes.
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