The ongoing opioid crisis is at the intersection of 2 substantial public health challenges: improving the treatment of pain and minimizing the harms that can arise from use of opioid medications. Recent Viewpoints in JAMA highlighted this tension. In one article, the authors emphasized that “there is no evidence that opioids are effective in chronic pain conditions and significant evidence that they cause harm,” and urged that they be used only as a “last resort.”1 In another article, the authors expressed dismay that federal policy has “disproportionately focused on reducing opioid use rather than increasing pain relief,” and that “excessive concerns” about opioids could “virtually eliminate” opioids as an option for chronic pain and could even deter physicians from prescribing small amounts for acute pain.2
Bonnie RJ, Kesselheim AS, Clark DJ. Both Urgency and Balance Needed in Addressing Opioid EpidemicA Report From the National Academies of Sciences, Engineering, and Medicine. JAMA. 2017;318(5):423–424. doi:10.1001/jama.2017.10046
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