By any measure, the opioid epidemic in the U.S. is a complex and major crisis. From the precipitous rise in overdose deaths and increasing rates of hepatitis C infections to a foster-care system overwhelmed by the children of families unable to care for them, “The scale of this problem is even more serious than we think now,” says University of Virginia law and medicine professor Richard Bonnie—and it is only getting worse.
This crisis has been in the making for years and will require many more to resolve, Bonnie says, conclusions that were among the findings of a recent study on the epidemic chaired by Bonnie and commissioned by the FDA. With a committee of experts in public health, ethics, medicine and law (with consultation from UVA law professor Margaret Foster Riley), the study set out to characterize the epidemiology of the epidemic, assess the FDA’s role in contributing to the crisis, provide an update on knowledge and practices in pain and pain management, and offer recommended actions. The committee’s report, “Pain Management and the Opioid Epidemic,” released last July by the National Academies of Sciences, Engineering, and Medicine, found that the epidemic grew from a convergence of factors, including a broad failure within our country’s health-care system to both understand and address chronic pain and to recognize the potential catastrophic impact of wide-scale prescription of opioids.