Is the government looking at the wrong source in its vigilance to reduce opioid abuse?

A former U.S. Drug “Czar” says yes.

William Bennett, the nation’s first drug czar, said this week on Fox and Friends that the debate about the opioid overdose epidemic wrongly focuses on prescription drugs.

(Here is Elizabeth Llorente’s story about the interview on Fox News.)

“The nature of the problem has changed in the last two or three years,” said Bennett, who served as Director of the Office of National Drug Control Policy under President George H. W. Bush. “It’s now fentanyl, it’s now heroin” that account for most of the overdoses.

“Most people, the vast majority of the people, who are prescribed these [painkillers] do not abuse them,” Bennett said. “The CDC had to come back and issue another kind of guidance, saying a lot of people who need pain pills are not getting them.”

Both the CDC and Food and Drug Administration (FDA) warned doctors last month not to abruptly stop prescribing opioid painkillers to patients who are taking them for chronic debilitating pain, generally lasting more than three months.

This is an interesting week for Bennett’s comments—given that the HHS Pain Task Force will release its final recommendations this week. This will be the latest federal guidance on how to best treat pain—and the use of opioids is certainly part of that prescription.

Since the Task Force—which has been receiving good marks for the thoroughness of its efforts—began its work, we’ve seen some backpedaling by federal agencies—notably the CDC and FDA—who believe efforts to curb opioid abuse is inadvertently hurting the chronic pain patient and others who use opioids to manage pain.

The recent article in the New England Journal of Medicine was cited by Surgeon General Jerome Adams recently.

It said in part, “We need better evidence in order to evaluate the benefits and harms of clinical decisions regarding opioid prescribing, including when and how to reduce high-dose opioids in patients receiving them long term.”

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