The best formula for abuse deterrence: Comprehensive pain management strategy

Rather than trying to apply a “fast fix” for abuse through the prescribing of abuse-deterrent opioids, prescribers must address the underlying factors that contribute to prescription medication abuse. Adoption of a comprehensive, evidence-based pain management program will support the complex needs of the injured worker in their path to functional rehabilitation.

The inability to significantly impact abuse through the prescribing of abuse-deterrent technology is rooted in the very nature of opioid analgesics. As long as these medications continue to act as they are intended — relief of pain by binding to opioid receptors of the brain, which in turn provides a feeling of euphoria — there will always be a potential for abuse. The greatest limitation of current abuse-deterrent technologies is that they do not address the underlying causes for abuse, which include dependence and addiction. These are best addressed by limiting opioid prescribing in the injured worker, and instead developing a comprehensive pain management plan tailored to a patient’s needs that includes both pharmacologic and non-pharmacologic components.

PREVENTING ADDICTION, ABUSE THROUGH COMPREHENSIVE PAIN MANAGEMENT

Evidence-based guidance rarely recommends the use of long-term opioid therapy in the treatment of the injured worker, yet 9 million people in the United States report chronic opioid use for medical reasons.¹ With this overutilization of long-term opioid narcotics, it is unsurprising that 7 out of 10 pharmaceutical drug overdose deaths involve these medications.²

Too often narcotic analgesics are prescribed as an easy fix. But evidence shows that they aren’t truly fixing anything. Long-term treatment with opioids is associated with poorer functional outcomes, including longer duration of disability.^3-5 Achievement of better outcomes requires a better strategy. The road to recovery for the injured worker is often not easy, but extraordinarily complex. A successful treatment strategy must be comprehensive enough to address the many needs of the injured worker, whether those needs are physical or psychosocial. It must also take into consideration the individual challenges faced by each unique patient.