Duke Expert: Opioid Public Health Emergency Is a First Step, But Many More Needed
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Thomas Buchheit, M.D., chief of the Pain Medicine Division in the Duke University Department of Anesthesiology, says the move today by President Trump to declare the nation’s opioid crisis a public health emergency is a first step among many. Buchheit notes that there is a tremendous amount of work to be done both in reducing the opioid burden in the United States and in developing novel, non-opioid analgesic solutions to treat patients with neurologic disorders, arthritis, and other painful conditions.
Opioid medication use has grown significantly in the past two decades. Currently, more than 4.3 million U.S. adults regularly taking opioid analgesics, and there are 90 deaths a day in the U.S. from opioid overdose. Although pain-related conditions cost an estimated $630 billion per year, only a small fraction of National Institutes of Health research is focused on treating these conditions, which negatively impact productivity, work and social lives.
Quotes: "There is no quick fix for the opioid crisis and no substitute for a comprehensive approach to pain management. We are in this difficult situation for a variety of reasons, including the excessive marketing of opioid analgesics and a system that rewards quick fixes over longitudinal and comprehensive care.
“We need to make sure we don’t marginalize pain patients or penalize doctors who try to take care of them in a truly compassionate manner. We’re seeing many primary care physicians who are no longer willing to prescribe opioids, even at low doses for low-risk patients, because of the concern over medical and legal liability. However, if we drive these patients outside the medical system, it will have significant negative unintended consequences, including increased death rates.
"The solutions are going to need to be thorough, bio-psycho-social evaluations, multifaceted treatments, widely available opioid weaning methods, and translational science that advances non-opioid therapies to treat chronic pain conditions."
Bio: Thomas Buchheit, M.D., is both a clinician as well as the chief of the Pain Medicine Division in the Duke Department of Anesthesiology. He has served in multiple leadership and educational roles, including as a current member of the board of directors of The Pain Society of the Carolinas and the Pain Medicine Committee of the American Society of Anesthesiologists. His research is focused on the clinical phenotypes of neuropathic pain, including the underlying epigenetic, proteomic, and metabolomic alterations that occur in the transition from acute to chronic pain.