FDA Seeks Better Regulation of Painkillers

AfterGlow

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By Alan Mozes, HealthDay Reporter
Feb 9, 2009

MONDAY, Feb. 9 (HealthDay News) -- The U.S. Food and Drug Administration announced plans Monday to tackle growing concern over the misuse of powerful painkillers by requiring manufacturers of certain opioid drugs to help develop a plan to reduce the risks associated with the medications.

The FDA said it has sent letters to 16 pharmaceutical companies that collectively manufacture the two dozen drugs that will be subject to the new review.

The requirement could ultimately take the form of additional warning labels, physician instructional materials, and stricter prescription indications, officials said.

Speaking at a Monday teleconference, Dr. John Jenkins, director of the FDA's Office of New Drugs, part of the Center for Drug Evaluation and Research, said that approximately 21 million prescriptions for 3.7 million patients were issued in 2007 for the targeted medications. They include brand-name and generic versions of morphine, oxycodone, fentanyl, and methadone.

Such drugs are typically approved for patients requiring round-the-clock treatment for moderate to severe chronic pain, such as cancer patients.

But, significant harm -- resulting in hundreds of deaths each year -- can occur if patients are uninformed about how to properly take the drugs; doctors inappropriately prescribe the drugs; or if legitimate prescriptions get into the hands of people other than the intended patient, Jenkins said.

Jenkins said the agency was taking this step to implement "a relatively massive new program," because "the rates of misuse and abuse [of opiates] have risen over the past decade." He also said the FDA was better able to address the problem, because the Food and Drug Administration Amendments Act of 2007 gave the agency the authority to regulate opioids.

Jenkins called the new program a multi-pronged and complex effort that will take several months to put in place, after an initial meeting with the drug manufacturers, scheduled for March 3.

Patient advocacy groups and health professionals involved with the treatment of pain and addiction will also be consulted during the development of the new drug protocols, which are officially known as "Risk Evaluation and Mitigation Strategies," or REMS.

This is "our attempt to try and ensure that the benefits of the products outweigh their risks," Jenkins said. To that end, he said, the FDA will try to strike an "appropriate balance" between legitimate patient need for access to such drugs and the very real threat posed by their abuse and intentional or unintentional misuse.

Also speaking at the press conference, Dr. Bob Rappaport, director of the FDA's division of anesthesia, analgesia, and rheumatology products, underscored the agency's growing concern over the inappropriate use of opiates by citing several alarming statistics.

For example, he noted a just released national survey that found that in 2007, 5.2 million Americans aged 12 or older said they had used prescription pain relievers in the prior month for non-medical purposes.

"So this is an ongoing problem, and it's getting worse," Rappaport said.

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Say hello to increased heroin sales to those already dependent on pharmaceutical painkillers who cannot be prescribed under the new regulations.
 
How is this NEWS? Oh well...glad I had my fun with opiates and I'm now on suboxone. Sounds like I was just in time, too. Glad to have had the experience. Loved opiates. Yeah, they destroyed my life, but there were some good times, too. Pretty sad, eh?
 
First of all, who is the FDA to regulate and quote to who and what a dr can prescribe? It is a right of all dr's to prescribe medicines for so called "off-label' use if they feel the benefits outweigh the risks. I am prescribed Fentora for non-cancer chronic btp, and it has been a godsend. The approved purpose if for cancer btp. I have been on it for 2 years. Does this mean that the FDA can step in and tell my dr that I cant have it anymore. It is ridiculous. I see an up and up pain mgt doc who counts pills, random drug tests, and sees us every month. I think it is up to the doctor/patient to regulate the meds, and not any government agency. There will always be conniving addicts, crooked doctors,etc, but it is going to hurt us honest patients WAY more than deter any addicts or diverters. Medicine is prescribed on a benefit Vs. Risk scenario. That is how it should stay.
 
Actually yes, the entire point of the FDA is to tell doctors what they can and cannot do with drugs. They are the Food & Drug Administration after all.
 
That's bullshit, they can approve or not approve a drug for a particular, recommended use. But they CAN NOT tell docs WHO and for WHAT they can prescribe the medicine. Each doc has the right to determine what will work best for their patient and their particular disorder. You must not be very educated when it comes to this subject, since you are not very versed on off-label use, which any doc can do. So the FDA should be for safety and nothing more. Every patient is different, and different drugs work better for each person. Should the FDA be able to say that oxycontin can only go to cancer patients, and methadone only to chronic non-cancer pain? THat is my point, the FDA should have no say in that.
 
So how is this gonna effect your average 22 year old white kid on 2 oc80s a day. Is the fda gonna come talk to my doc and bust up my chill?
 
This REMS is gonna be a panb in the ass if you even dabble in opiates. I'll be you anything they want to ban methadone for pain -- thanks the big drug companues -- methadone is only $50 a month to treat for pain -- the cheapest and the best -- esepcially for people with noisnurance or rx discount....SO....that's why the big dfrug companies want to ban methadone for pain -- so we will have to buy their 1000$ OxyContin -- which Purdue has rendered inert with its recent Matrix change -- and the 800$ FEntanyl.....It's pushign pain control back into the dark ages....and it's only fueling streeet opiates -- get ready heroindealers...we'lll all be conmingyour way when this RWEMS things starts -- even grandmothers willl shot dope is they've been on methadone for 10 yeaser for a brokenback and then the govn't BANS it -- but her tolerance is so high that nothing else works.....So here's a heroin addicted pain patients grandmother -- thansk to the govn't. Oh she could go and stand in line at the meth clnic -- letem try to close those down -- there wouldn't be enough jails to put the 250,000 people who are on MMT now. ANd there are 750,000 people onMEthadone for CP -- and you are going to BAN IT BECAUSE IT MAY CAUSE THE SAME HEART RISHS THAT DOZENS OF OTHER MEDS CAUSES? PLEASE......
 
The FDA permits off-label use. It's up to them.

How would the FDA go about stopping off-label use? Even if they do it for just controlled meds, they are asking for a shitstorm. Keep in mind, NEARLY NOTHING is approved for use in pediatrics. Gotta stop pain somehow.
 
The FDA cannot stop off-label use, the problem here, is finding a doc that believes in such remedies.

Its an old-school mentality to say to someone shooting heroin, here eat these Roxi's instead. Sure, maybe its 50-50 some will bang them all day and some will switch to eating, but too many people have seemed to ruin it for our generation.

I doubt my children will be able to doctor shop the way I did. Who is really being protected here, haha?
 
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