A New Pain Medication Could Reinforce the Disastrous Crackdown on Prescription Opioids
Vertex Pharmaceuticals is trumpeting the results of clinical trials indicating that VX-548, its new, non-opioid analgesic, is effective at relieving post-surgical pain. While there is nothing wrong with offering patients and doctors another option for treating acute pain, the Phase 3 trials found that VX-548 was no more effective than a combination of hydrocodone and acetaminophen in relieving pain after tummy tucks and less effective for patients who had bunions removed.
As a new drug under patent, VX-548 is bound to be much more expensive than generic versions of Vicodin, and its main selling point seems to be based on a gross exaggeration of that familiar drug’s addictive potential. The introduction of VX-548 therefore could reinforce myths about the risks of prescription opioids and encourage the government’s misguided and heavy-handed crackdown on those medications.
“People who are suffering from severe pain but don’t want to risk addiction to an opioid are closer to a new option for treatment,” The Wall Street Journal reports. The Journal claims “opioids are highly addictive,” which is not true by any reasonable measure.
A 2018 BMJ study of 568,612 patients who took prescription opioids following surgery found that 5,906, or 1 percent, showed documented signs of “opioid misuse” during the course of the study, which included data from 2008 through 2016. The outcome measure that the researchers used, “opioid dependence, abuse, or overdose,” is a broad category that includes patterns of use falling short of what most people would recognize as addiction. That suggests the actual addiction rate in this study probably was less than 1 percent, although it’s not clear how much less. The authors noted that “overall rates of misuse were low.”
Estimates of addiction rates among patients who take opioids for longer periods of time tend to be higher but still lower than the phrase “highly addictive” suggests. A 2010 analysis in the Cochrane Database of Systematic Reviews found that less than 1 percent of patients taking opioids for chronic pain experienced addiction. A 2012 review in the journal Addiction likewise concluded that “opioid analgesics for chronic pain conditions are not associated with a major risk for developing dependence.”
In a 2016 New England Journal of Medicine article, Nora Volkow, director of the National Institute on Drug Abuse, and A. Thomas McLellan, a former deputy director of the Office of National Drug Control Policy, reported that “rates of carefully diagnosed addiction” in chronic pain patients averaged less than 8 percent. In general, they observed, “addiction occurs in only a small percentage of persons who are exposed to opioids—even among those with preexisting vulnerabilities.” In 2021, a California judge who examined the relevant evidence likewise estimated that the addiction rate among patients was “less than 5%.”
Even a low risk is
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