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11 Articles in Volume 14, Issue #4
Recognizing and Treating Concussions Related to Sports Injuries
CDC Initiative: Concussion in Sports and Play
Pain Management After ACL Surgery
Risk Assessment in the Digital Age: Developing Meaningful Screening Tools for Opioid Prescribers
Testosterone Replacement: Essential in Pain Management
Why Is There Hydromorphone In My Patient’s Urine?
Benzodiazepines in Pain Practice: Necessary But Troubling
Commentary: Risk Assessment in the Digital Age
Zohydro Debate: Drug Hysteria or True Concern
Benefit of Long-acting Versus Short-acting Opioids?
Epidural Steroid Injections, Coping Skills, Medical Marijuana

Zohydro Debate: Drug Hysteria or True Concern

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A number of legislators, some who may have received Pharma money, have railed against Zohydro. New York State Senator Chuck Schumer appealed to Kathleen Sebelius to overrule the FDA. He appeared with someone who had lost a family member in a pharmacy robbery. So, that is why we should ban Zohydro? Senator Joe Manchin wanted Zohydro off the market, and he stated that this is “life or death for West Virginia!” His daughter happens to be the CEO of Mylan Labs, whose drugs include: morphine, oxycodone, and hydrocodone. Zohydro will take away market share from Mylan.

New laws have been discussed, both statewide and nationally, to ban Zohydro. U.S. Rep. Stephen Lynch introduced legislation surrounding Zohydro. Governor Deval Patrick of Massachusetts actually prohibited Zohydro from being prescribed in his state. Zogenix challenged this (probably illegal) decision, and won the first round in court. The Governor of Vermont, Peter Shumlin, issued an “emergency order” rendering it more difficult to prescribe stronger painkillers, including Zohydro. These are deeply troubling actions, whereby politicians override the FDA experts.

As noted, 29 state attorney generals have asked the FDA to overturn its decision. These attorney generals prosecute drug crimes; they are not in the trenches with the suffering pain patients. Even Dr. Oz has jumped on the anti-Zohydro bandwagon.

Despite the intense pressure, the FDA has held its position, consistently defending the Zohydro decision.

There is a legitimate opioid abuse problem in this country. The use of Zohydro may actually decrease abuse, as it is longer acting than the current hydrocodone versions. The opponents of Zohydro insist that it should contain “abuse deterrent” technology, as if that is an answer to our opioid problem. “Abuse deterrent” drugs possess an extra ingredient, rendering it difficult to snort or inject the opioid. There is no evidence that this actually deters abuse, and these new formulations have increased side effects and costs. Approximately 96% of the overdoses with opioids occur when people ingest the medicine with alcohol and/or other sedatives. Only a few percent actually overdose by injection. We are punishing the tens of millions of legitimate chronic pain patients because of the small percentage of abusers.

Nothing good happens when uninformed lay people dictate our public health policy. In 2004 the U.S. Congress, along with the Attorney General of New York, exerted intense pressure on the FDA to place a “black box” warning on antidepressants. These warnings led to a decrease in the diagnosis of depression among youths, and ultimately correlated in increased suicides. More recently, Hollywood celebrity Jenny McCarthy led the anti-vaccine movement, which resulted in a dramatic increase in whooping cough, along with other preventable illnesses.

We desperately need better therapies for chronic pain, including medications and other treatments. Opioids are far from ideal, but for many with severe pain they greatly improve quality of life. Zohydro will be a good drug for many pain sufferers, without damaging their liver and kidneys. Unfortunately, many in the media, along with certain legislators, are attempting to drive Zohydro off the market. That would be a tragedy.

Last updated on: May 19, 2015