"Who is most at risk for addiction to pain killers?" and "How do you balance getting adequate pain relief with the risk of addiction?" were only two of the many questions discussed at today's Pain, Opioids, and Addiction: An Urgent Problem for Doctors and Patients conference, sponsored by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH). More than 500 researchers, clinicians and interested consumers gathered on the NIH campus to discuss the growing problem of prescription painkiller abuse and the potential for addiction in patients with chronic pain conditions. The conference is being held in collaboration with the NIH Pain Consortium and the American Medical Association.
"This meeting brings together experts on both the research and clinical sides to discuss issues surrounding both the benefits and risks of prescription pain relievers, and to look at best practices that minimize the risk of addiction," said NIH Director Dr. Elias A. Zerhouni. "It is part of our ongoing commitment to use the best science available to inform medical practice."
"We are meeting to discuss how scientific research can contribute to safer solutions for patients in need of pain relief," said NIDA Director Dr. Nora D. Volkow, who gave welcoming remarks at the conference. "With high rates of non-medical abuse of opioid pain relievers, particularly among young people, we view this as an urgent priority."
The 2006 Monitoring the Future Survey, funded by NIDA, showed that one in ten high school seniors have used the painkiller Vicodin for non-medical purposes in the past year, with high rates for other prescription drugs as well. Today's conference participants looked at how adolescents' motivations for opioid abuse can predict other kinds of substance abuse. In addition, scientists discussed the brain mechanisms underlying both pain and addiction and how a genetic variation that alters how some people respond to stress can make them more vulnerable to addiction.
The increase in opioid abuse may be due in part to the growing numbers of prescriptions written for narcotic pain relievers, such as Vicodin and Oxycontin. However, when used properly, prescription opioids can have many beneficial effects, helping those suffering from chronic pain to lead relatively normal and productive lives. Because abuse of and addiction to opioid medications in the context of chronic pain is not well understood, scientists will be discussing this among other issues. For example, attendees today heard that when prescribed for cancer pain, opioids might have less potential for abuse.
In parallel, scientists are trying to develop new ways to treat pain without the risks of abuse and addiction. On Tuesday, for example, there will be more discussion about the development of a newer generation of pain relievers devoid of tolerance or dependence. They will also discuss real-time functional magnetic resonance imaging (rtfMRI) as a tool to allow patients to better manage their own pain, through the actual visualization and control of brain activity in regions associated with pain processing.