This article evaluates abuse-deterrent formulations (ADFs) as a method to reduce prescription drug abuse while ensuring access to vital medications for individuals with legitimate need; assesses the pros and cons of ADFs and the current state of ADF adoption in the market; and develops policy recommendations to transition the market to ADFs. Although abuse-deterrent technology is still in its nascent stages, ADFs have been proven to reduce prescription drug abuse and its consequences, and even an incremental reduction in abuse can have a significant impact on the nation by reducing the costly social, physical, mental, and public health problems resulting from abuse. Federal ADF policy does not reflect the urgency of the prescription drug abuse epidemic and does not go far enough toward changing the status quo. Policies must be implemented to encourage innovation and a market shift toward ADFs by ensuring any generic medication that references a branded ADF demonstrates that it does not have abuse-deterrent properties inferior to the branded ADF product. Policies must also require federal prescription drug benefit plans to cover ADFs to ensure consumers have access to such medications.
The vast majority of Americans experience low back pain at some point in their lives. For some, it is a fleeting nuisance that can be remedied with over-the-counter treatments, but others suffering from chronic low back pain require more advanced treatments, including opioids, biologics, or surgery. Studies have shown trends of overtreatment of chronic back pain, using opioids without a corresponding improvement in patient outcomes. This article examines the impact of misdiagnosis and improper treatment of chronic low back pain, taking a specific focus on the impact of inappropriate opioid treatment. It instructs practitioners to make a differential diagnosis and sets forth policy recommendations to ensure that practitioners are properly educated on this topic.
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