The FDA and Chronic Pain Management

A Federal Drug Administration (FDA) panel voted narrowly (20 to 17) in June 2009 to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver. Having seen people abuse both of these medications I have mixed thoughts about the efficacy of this proposed ban. I’m conflicted because I have also seen the improved quality of life of many others who received adequate pain relief from this type of medication. Many healthcare providers also don’t understand the logic behind banning a drug which, when taken as prescribed, won’t harm a patient.

In July of this year the FDA announced it would place only a warning label on propoxyphene (Darvon), which also includes acetaminophen, leaving many healthcare providers hopeful that the FDA will go against its advisory board and also keep Vicodin and Percocet on the market. The same FDA panel also voted 36-1 that if the Percocet and Vicodin are not banned from the market; they should be given a black box warning, the FDA's most severe warning label.

One of the reasons I am taking this issue so seriously is the serious impact this proposed ban will have on pain management. Not just for acute pain situations like serious bone breaks, major dental procedures etc., but also in the chronic pain management arena. Many healthcare providers have traditionally used medications like Vicodin and Percocet for breakthrough pain for people undergoing cancer treatment or other serious types of chronic pain conditions.
I also believe that anyone undergoing chronic pain management should develop a safe and effective medication management plan if they are on any medications that have serious risk factors. An important part of developing an effective chronic pain management plan is to develop an understanding of what an effective plan looks like.

I recommend that this type of plan requires a three part approach:

(1) A medication management plan which includes a medication management agreement;

(2) A cognitive-behavioral treatment plan that addresses pain versus suffering by learning how to managing thoughts and feelings, as well as changing self-defeating behaviors and problematic social/family reactions; and

(3) A nonpharmacological (non-medication) pain management plan which supports the development of safer ways to manage pain.


To learn more about developing a medication management plan please check out my last month’s article 12 Personal Action Steps for Chronic Pain Medication Management that you can download for free on our Ariticles page.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.


You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are living with chronic pain, especially if you're in recovery or believe you may have a medication or other mental health problem and want to learn how to develop a plan for managing your pain and medication effectively, please go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here. To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.