The opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain, and containing the rising toll of harms related to opioid use.
Millions of Americans experience pain each year. Chronic, or long-term, pain is associated with serious health problems, such as depression, and social problems, such as decreased work productivity. While opioids are effective for managing short-term pain, cancer pain, and pain at the end of life, it is not clear that opioids benefit people with chronic pain.
Using opioids long-term is associated with greater health risks. Rates of opioid use disorder (addiction to prescription opioids), overdose, and other related harms have risen with greater availability of opioids over the past two decades, even as opioid prescribing is declining in recent years. In fact, drug overdose—mostly linked to opioids—is now the leading cause of unintentional injury deaths in the United States.
It will take years of sustained and coordinated effort to contain the current opioid epidemic and stem its harmful effects on society.
The Committee’s Assignment
Recognizing the magnitude of the opioid crisis, in March 2016, the U.S. Food and Drug Administration (FDA) asked the National Academies of Sciences, Engineering, and Medicine to convene an ad hoc committee to
- update the state of the science on pain research, care, and education since publication of the 2011 Institute of Medicine (IOM) report Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, including the evolving role of opioids in pain management;
- characterize the epidemiology of the opioid epidemic and the evidence on strategies for addressing it;
- identify actions the FDA and other organizations can take to respond to the epidemic, with a particular focus on the FDA’s development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring; and
- identify research questions that need to be addressed to assist the FDA in implementing this framework.