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In Reply We agree with Drs Ballantyne and Kolodny that opioid analgesics are not the most effective treatment option for certain types of chronic pain. This recognition, combined with the public health risks associated with opioid analgesics, prompted revisions to the indications for ER/LA opioid analgesics in 2013.
Manufacturers must now instruct prescribers to “reserve [ER/LA opioid analgesics] for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.”1 In addition, in recent years, the FDA has approved several nonopioid medications to treat some of the most common chronic pain conditions.
Jones CM, Lurie P, Woodcock J. Preventing Prescription Opioid Abuse—Reply. JAMA. 2015;313(10):1060-1061. doi:10.1001/jama.2015.0524