WASHINGTON (AP) — How do you have a conversation about prescription drugs that provide critical pain relief to millions of Americans yet also cause more fatal overdoses than heroin and cocaine combined?
The answer is: It depends.
Different parts of the federal government describe the problem — and potential solutions — of abuse with Vicodin, OxyContin and other opioid drugs in different terms.
The White House has called opioid abuse an “epidemic” and a “growing national crisis” that causes more than 16,500 deaths per year. Meanwhile, the head of the Centers for Disease Control and Prevention and a top-ranking Drug Enforcement Administration official have called on doctors to dramatically scale back their use of prescription opioids.
But while Food and Drug Administration Commissioner Margaret Hamburg acknowledged that opioids are overprescribed in an interview with The Associated Press, she again emphasized the importance of keeping the drugs accessible to Americans with chronic pain — a group she cites as roughly 100 million, or about 40 percent of U.S. adults.
“I think we have an important balancing act of trying to assure that safe and effective drugs are available for patients who have real pain and need medical care,” Hamburg said.
The agency’s approach has won kudos from physicians who use opioids to treat pain, including the American Pain Society, a group that receives funding from the largest pain drugmakers, including Pfizer Inc. and Teva Pharmaceuticals.
But it also exposes a rift in the government’s messaging about the appropriate role of opioids, which are among the most frequently prescribed drugs in the U.S. CDC officials have called for more limited prescribing, citing figures that show a four-fold increase in opioid sales between 1999 and 2010, during which opioid overdose deaths more than tripled.
“These are dangerous medications and they should be reserved for situations like severe cancer pain where they can provide extremely important and essential palliation,” CDC Director Tom Frieden said. “In many other situations, the risks far outweigh the benefits.”