A white paper is an official report, often from a government of other authoritative source, providing information or making proposals on a given issue. It is often bound in white, hence the moniker, white paper. In January of 2015, National Institutes of Health (NIH) released a white paper on the effectiveness of opioid drugs in treating long-term chronic pain.
Pain Treatment with Opioid Drugs
According to an online article published in MedicalXpress, the NIH white paper found “little to no evidence” on the effectiveness of opioid drugs in treating chronic, long-term pain. The results reported in the white paper are positioned against the fact of explosive growth in opiod drug use.
The NIH convened a seven-member panel in the fall of 2014, and the white paper is the panel’s final report. Panel findings revealed that many studies used to justify prescribing opiod drugs were conducted poorly, or were of insufficient length.
One author of the study, Dr. David Steffens, notes that the prolific use of opioid drugs is surprising based on the white paper findings. Moreover, Steffens said that in regards to long-term pain, there is “no research-based evidence” that opiod drugs are helpful.
Despite the facts of the matter, the number of opioid drug prescriptions has seen a three-fold increase in the past two decades. The study found that upwards of 219 million prescriptions were written for the drugs in 2011 alone.
Concurrent with the explosive prescribing is the explosive rate of opioid drug abuse, and many regard the escalating abuse of prescription drugs to be of epidemic proportions. According to the Centers for Disease Control (CDC), opiod drug overdoses took the lives of more than 16,000 people in 2012 alone. The CDC also cites drug overdoses as causing more deaths in those aged 25-64 than motor vehicle accidents.
Opioid Use and Abuse
The United States consumes 80 percent of the opiod drugs worldwide, yet has only 4.6 percent of the population. Such a level of use and abuse of opioids by Americans makes it “a peculiarly American problem”, according to Dr. Steffens.
Steffens found the white paper findings surprising, particularly in light of the fact that Steffens along with other panel members, are not experts on opioid drugs, pain managements or drug abuse. Panel members are experienced in other fields of medicine, and were chosen intentionally by the NIH to avoid any conflicts of interest and to get a clear perspective on this issue.
One challenge facing the panel on this issue was the fact that opioid drugs can be an effective treatment for some individuals who are dealing with pain. At the same time, it can be difficult to predict when trouble will result from their use. One problem noted was the need for “best practices” to be better communicated to physicians prescribing opioid drugs.
Dr. Steffens cited fibromyalgia as an example of a syndrome in which opiod drugs were less likely to be effective, and more likely for patients to get into trouble with abuse of the drugs.
Drug diversion was another issue the panel pointed out as problematic to patients, as well as society at large. The opioid drugs prescribed and obtained from the pharmacy can end-up being diverted—sold on the streets or given away. Drug diversion is already knows to be a driving force in the escalating prescription drug-abuse problem.
Steffens noted he wishes that doctors would be cautious in dispensing pills to they are treating for sports or workplace injuries.
The NIH white paper results warrant more research on the effects of opioid drug use, and prudence in their use in treating pain issues.