Reuters
FDA Commissioner Scott Gottlieb
- FDA officials say the next wave of drug abuse will involve opioid substitutes.
- These substitutes include gabapentinoids, loperamide, benzodiazepines, and kratom.
- "We must be aware that any decisive actions taken to reduce prescription opioid abuse and stem the tide of overdose and death can have unintended consequences, including prompting people to turn to alternative, potentially dangerous substances," the officials wrote in a recent letter published in the New England Journal of Medicine.
New addiction trends seem to materialize overnight. For the FDA, every drug is a potential suspect.
In a letter published Wednesday in the New England Journal of Medicine, FDA officials Douglas C. Throckmorton, Scott Gottlieb, and Janet Woodcock warned that non-opioid pain killers could be on the forefront of the next wave of drug abuse.
"We must be aware that any decisive actions taken to reduce prescription opioid abuse and stem the tide of overdose and death can have unintended consequences, including prompting people to turn to alternative, potentially dangerous substances," the officials wrote in the letter.
There were more than 42,000 deaths in the US attributed to opioids in 2016, and 40% of all opioid overdose deaths involve prescription opioids. The FDA is taking proactive measures in response to this crisis, which include reducing excess amounts of opioids in circulation, encouraging doctors to prescribe drugs other than opioids when possible, and developing new therapeutics that can help patients suffering with pain.
But efforts to curb prescription opioid abuse by the FDA could effectively shift use to opioid substitutes instead.
Substances that are currently closely watched are gabapentinoids which are used to treat seizures and neuropathic pain, loperamide which is an over-the-counter treatment for diarrhea, benzodiazepines which are used to treat anxiety, and kratom, a plant-based drug widely used as a recreational opium substitute.
These drugs have been found to either contain unrecognized opioids or have potentially lethal opioid effects. While these drugs are safe when used appropriately, instances of misuse have sparked the FDA's attention.