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ARPO Response to the Obama Administration “Epidemic” Prescription Drug Plan

The recently released Obama Administration prescription drug abuse plan, correctly entitled “Epidemic” and appropriately labeling the problem a “crisis”, was sorely needed and long overdue. While the plan’s inclusion of enhanced education, monitoring, disposal, and enforcement is commendable, its failure to incorporate several critical components of truly effective prescription opioid reform is troubling to a number of medical and advocacy groups, including ARPO (Advocates for Reform of Prescription Opioids). These omissions are similar to those of the FDA’s earlier REMS proposal which was termed “inadequate” by its own Advisory Committee, and unless they are corrected, will significantly limit achievement of the Administration’s stated goals.

The first deficiency is the plan’s intent to assign the development of mandatory physician education in proper prescribing and management of these drugs to the relevant drug manufacturers. Many of these companies have already been disciplined by the government for product misrepresentation and unethical marketing practices, and the recent expose’ of their involvement with the University of Wisconsin Pain Group reinforces the reality that trusting drug manufacturers to ignore their obvious profit motive in designing physician training protocols is akin to the fox guarding the henhouse. Instead, only an independent, unbiased, credible, and scientifically expert entity such as Physicians for Responsible Opioid Prescribing (PROP) should be given this important task, one which should include non-pharmacologic treatment methods that have also been proven effective.

An even more bothersome aspect of the Administration’s new plan is that it essentially ignores the central issue of the prescription opioid epidemic--the horrendous over-supply and over-availability of these drugs. Current prescribing indications permitting use of opioids for chronic non-cancer pain are not supported by research demonstrating effectiveness, while these drugs are known to embody significant lethality and addiction potential and many adverse side effects. The linear relationship over the last ten years between the relentless increase in prescribed opioid drugs and the rising morbidity and mortality attributable to them clearly demonstrates the fallacy of a plan focusing on the end of the “pipeline” rather than the beginning--ie, the supply. Restricting use of prescription opioids to short-term severe and cancer pain, and limiting their off-label use would effectively address this oversight without compromising availability of these drugs to those pain patients who meet evidence-based criteria and whose benefit from them outweighs their drawbacks.

Setting a goal of reducing the non-medical use of prescription opioid drugs by only 15% is the third disconcerting part of the Administration’s new plan. Even as a short-term objective, this anemic figure calls into serious question the government’s understanding of and commitment to reducing the public health and societal devastation represented by the prescription opioid crisis. It also raises anew the issue of the nature and extent of the relationship between the federal government and the pharmaceutical industry. Considering the degree of the prescription opioid crisis’ negative impact on the nation, the only acceptable goal should be to eliminate the non-medical and inappropriate medical use of these drugs.

ARPO firmly believes that implementing the above two recommendations would constitute a good first step toward a degree of reduction more in keeping with the magnitude of the prescription opioid drug epidemic. ARPO, as a bi-national non-profit organization comprised of families, medical professionals, and other advocates in the U.S. and Canada, is dedicated to the regulation, marketing, prescribing, and use of prescription opioid drugs in an evidence-based and ethical manner. Its members have testified before Congress and the FDA, submitted Citizen Petitions and formal REMS proposals to the FDA, and formed coalitions with other similar groups to educate the public and the media about the myths and realities of prescription opioids. ARPO is irrevocably committed to eliminating the epidemic of death, addiction, and devastation caused by these drugs.

Most recently, ARPO has collaborated with U.S. Representative Mary Bono Mack (Calif.), who has supported Congressional involvement as a needed and productive mechanism for prescription opioid drug reform, convened hearings on the opioid crisis, and introduced legislation to favorably impact the opioid epidemic.

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Signed by

Mary , May 17th 2011
Richard Marshal, May 17th 2011
Richard Marshall, May 17th 2011
Debera Murtaugh, June 2nd 2011
Ellen Arnold, June 2nd 2011
Marcella R Huguelet, June 2nd 2011
Ed Bisch, June 3rd 2011
Franca Bombino, June 6th 2011
Marisa Tedeschi, June 6th 2011
Natasha Onorati, June 6th 2011
Sandra Finocchi, June 6th 2011
Bill Roeder, June 7th 2011
Layne A. Kresser, June 7th 2011
Lynn Kresser, June 7th 2011
Sandra Kresser, June 7th 2011
Kaylene Johnson, June 8th 2011
Meisha Kresser, June 8th 2011
Paul Johnson, June 8th 2011
Rose Arturir, June 10th 2011
Rosemary Orr, June 11th 2011
CONNIE MASUCCI, June 13th 2011
Frances Ciabattoni, June 13th 2011
Billy Guiboche, June 14th 2011
Janet Schnitzer, June 14th 2011
Mena Salpietro, June 14th 2011
Paul Duran, June 14th 2011
Pete Jackson, June 16th 2011
Kim Smith, June 20th 2011
C. Bisket, June 25th 2011
Carol Maccormick, June 25th 2011
David Lear, June 25th 2011
J. Martin, June 25th 2011
Sandy McCann, June 26th 2011
John & Joan Bagby, June 28th 2011
Pierrette Stinson, June 28th 2011
Carolyn Green, June 29th 2011
THERESA HUTTER SR, June 29th 2011
JEAN PORTER, June 30th 2011
Tim Taylor, July 2nd 2011
Eva Pietrangelo, July 12th 2011
Karen L. Tyler, July 20th 2011
Maria M. Dutra, July 20th 2011
Nora Acevedo, July 20th 2011
Carrie Pfenning, July 21st 2011
Michael Ross, July 24th 2011
Chase Tsampiras, July 28th 2011
Chris Whittaker, July 28th 2011
Ross Figliano, July 28th 2011
Mariel Chandler, July 30th 2011
Jasion Elizabeth, August 2nd 2011
Wojtkun G, August 2nd 2011
Ada Giudice-Tompson, August 19th 2011
Brian Roberts, October 2nd 2011
fred zwicker, October 2nd 2011
Ed Vanicky, October 2nd 2011
Valerie Loveys, October 2nd 2011
Leslie Tilley, October 2nd 2011
justin saranillio, November 12th 2011
Brigitte van Essen, November 13th 2011
lisa seitz, December 17th 2011
Andrea Hughes, December 27th 2011
Rachel Hetzel, December 27th 2011
Tenielle Carter, December 28th 2011
Heather Baxter, December 31st 2011
Jack Wade, January 1st 2012
Joel Wolf, January 9th 2012
Jim Russo, January 9th 2012
Tami Nelson, January 22nd 2012
Erich Curnow, January 26th 2012
Lisa Cyr, January 27th 2012
Cathy Taughinbaugh, January 27th 2012
Trudy Duffy, January 28th 2012
Suzanne Lee, January 29th 2012
Bill Lee, January 29th 2012
Lori Santos, January 30th 2012
Beth Good, January 31st 2012
karen gravina, February 1st 2012
kristina richards, February 1st 2012
Cheryl Placek, February 21st 2012
Robert Gibbison, March 12th 2012
Sandy Douros, March 12th 2012
Ann Krikken, March 13th 2012
Sharon Gamble, March 14th 2012
Terry Talbot, March 14th 2012
Mary Brophy-Lee, March 14th 2012
Gayle Newman, March 15th 2012
Maena Whitelegge, March 16th 2012
jackie murphy, March 31st 2012
Sue Adler Kaufman, April 5th 2012
deborah lehti, April 7th 2012
chris tolman, May 11th 2012
Patricia Goodwin, May 12th 2012
Lisa Micich, May 18th 2012