Pain Treatment


Powerful Narcotic Painkiller Up For FDA Approval

(Getty Images)

(Getty Images)

by Rob Stein, NPR

The Food and Drug Administration is trying to decide whether to approve a powerful new prescription painkiller that’s designed to relieve severe pain quickly, and with fewer side effects than other opioids.

While some pain experts say the medicine could provide a valuable alternative for some patients in intense pain, the drug (called Moxduo) is also prompting concern that it could exacerbate the epidemic of abuse of prescription painkillers and overdoses.

An FDA advisory committee is holding a daylong hearing Tuesday to decide whether to recommend that the agency approve the drug.

“This is a product that is very easy to misuse, very easy to crush and snort or crush and inject,” says addiction specialist Andrew Kolodny.

Moxduo for the first time combines morphine and oxycodone in one capsule. It’s designed to provide quick relief to patients suffering severe pain from accidents or surgeries, such as knee replacements, back surgeries or cancer operations, says Ed Rudnic, COO of QRxPharma, the company that makes Moxduo.

The drug allows patients to take lower doses of the two narcotics than they’d need if they took either of the medicines alone, Rudnic says.

“We believe that we’ve achieved some benefit in reducing the risk of some of the respiratory complications of these strong opioids,” he says.

Suppressed breathing and other respiratory complications are the most serious risks of these drugs — the main reason people die from taking too much.

Some pain experts think the idea behind Moxduo is a good one. A lot of patients can’t take enough morphine or oxycodone to ease their discomfort because of the risk to breathing and other side effects, such as nausea, vomiting, dizziness and severe itchiness.

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FDA Seeks to Tighten Control on Hydrocodone Painkillers Like Vicodin



By Rob Stein, NPR

The Food and Drug Administration Thursday announced that it wants the federal government to impose tough new restrictions on some of the most widely used prescription painkillers.

The FDA said it planned to recommend that Vicodin and other prescription painkillers containing the powerful opioid hydrocodone be reclassified from a “Schedule III” drug to a “Schedule II” drug, which would impose new restrictions on how they are prescribed and used.

OxyContin, another opioid painkiller, is already a Schedule II drug, defined by the Drug Enforcement Administration as “potentially leading to severe psychological or physical dependence”.

In a statement posted on its website, the agency said it was taking the step after becoming “increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.” Continue reading

A Painful America

(Photo: Paul Bradbury)

(Photo: Paul Bradbury)

The numbers are staggering. One hundred and sixteen million Americans experience pain that can last from weeks to years. Costs of treatment and lost wages total between $560 and $635 billion each year. Yet treatment does not always relieve a patient’s suffering.

In a Perspective published today in the New England Journal of Medicine, researchers outline how significant the problem of pain is in the U.S. and suggest approaches for more effective therapy. The piece recaps last year’s Institute of Medicine Report, Relieving Pain in America.

The writers say that undertreated acute and chronic pain is a “significant overlooked problem.” Dr. Phil Pizzo, Dean of Stanford’s Medical School, is co-author of today’s Perspective and led the IOM committee that reviewed the issue last year. In an interview, he described that both patients and doctors have differing approaches to pain and how to manage it. Some patients feel they need to tough it out. Others need someone to listen and work with them. Doctors may be either caring or judgmental about a patient’s pain. Continue reading