Feb. 15, 2022 – Drugmakers in the 1990s marketed new opioids as less addictive and pushed for wider use among patients.

“We overdid it with prescription medications – we were kind of sold a bill of goods by pharmaceutical companies that told us, no, these things are not addictive,” said Bryce Pardo, associate director of the Rand Corporation’s Drug Policy Research Center.

In reaction to the rising opioid overdose crisis, new rules in the late 2000s made it more difficult to prescribe the drugs – and around the same time, overdose deaths from illicit opioids began rising.

“We turned the tap off too quickly without really trying to increase the access to drug treatment programs,” Pardo said. Substance dependence treatment didn’t expand as quickly as patients needed.

“I think that’s what CDC is trying to do by relaxing some of the prescription guidelines now because they realize, well, we may have overdone it by trying to cut people off too quickly,” Pardo said.

But, he argued, the guidance shouldn’t go too far in the other direction: “We ping-pong back and forth between extremes.”

The new guidelines need to strike a delicate balance between making sure patients with serious pain have access to the medications they need, but also not introducing new patients unnecessarily to opioids, he said.

People in chronic pain can “manage their lives fine on an opioid – that’s fine. What we don’t want is a 19-year-old who blew out his knee at football practice getting 90 days’ worth of prescription medication.”

It’s difficult to reach that balance, said Nicholson, who called it “the Goldilocks solution”.

“There was a harm from overly liberal prescribing, so I do think the CDC stepped in in order to try and stem that harm,” she said. But “the people who actually needed it got caught in the crosshairs of this pendulum swing.”


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