What You Need to Know:

An unprecedented judgment from an Oklahoma judge was leveled at corporate giant Johnson & Johnson on August 26th when the company was ordered to pay more than $572 million for pressing physicians to prescribe opioids while minimizing known risks for addiction. Judge Balkman stated that the company used misleading marketing and promotion of opioids which lead to a nuisance in the state, causing more than 6,000 deaths over 20 years. The company plans to appeal the decision saying state prosecutors misinterpreted the public nuisance law.

In the late 1990s pharmaceutical companies told medical providers that opioid pain relievers would not lead to addiction, which caused a surge in opioid prescriptions. Coinciding with this timeline, deaths due to drug overdoses increased four-fold since 1999. In 2017, nearly 48,000 overdose deaths involved a prescription or illicit opioid which prompted the U.S. Department of Health and Human Services (HHS) to declare a public health emergency that same year.

HHS has proposed a five-point strategy to combat the opioid crisis:

·         Improve access to treatment and recovery services

·         Promote use of overdose-reversing drugs

·         Improve understanding of the epidemic through public health surveillance

·         Provide support for cutting edge research on pain and addiction

·         Advance better pain management practices

The Centers for Disease Control and Prevention (CDC) has also developed a strategy to battle the opioid crisis, which consists of three key points:

• Determine when to initiate or continue opioids for chronic pain
• Opioid selection, dosage, duration, follow-up, and discontinuation
• Assess risk and address harms of opioid use

There are many challenges surrounding the use and abuse of opioids, which creates serious issues for clinicians treating patients with acute and chronic pain. Opioids are an effective option to control pain, but the risks of addiction and overdose must be carefully weighed against the benefits.

Read More about Opioid Abuse and the Opioid Crisis:

The Atlas of Emergency Medicine: Chapter 17. Toxicological Conditions > Opioid Toxicity

Morgan & Mikhail's Clinical Anesthesiology, 6e: Chapter 47. Chronic Pain Management

The Color Atlas and Synopsis of Family Medicine, 3e: Chapter 247. The Opioid Crisis and the War on Drugs

Essentials of Psychiatry in Primary Care: Behavioral Health in the Medical Setting: Chapter 6. Misuse of Prescription Substances and Other Substances

Centers for Disease Control and Prevention: CDC’s Response to the Opioid Overdose Epidemic

The Atlas of Emergency Medicine: Chapter 17. Toxicological Conditions > Opioid Toxicity

Morgan & Mikhail's Clinical Anesthesiology, 6e: Chapter 47. Chronic Pain Management

The Color Atlas and Synopsis of Family Medicine, 3e: Chapter 247. The Opioid Crisis and the War on Drugs

Essentials of Psychiatry in Primary Care: Behavioral Health in the Medical Setting: Chapter 6. Misuse of Prescription Substances and Other Substances

Centers for Disease Control and Prevention: CDC’s Response to the Opioid Overdose Epidemic