Can Francis Collins Help Solve the Opioid Crisis?


The problem of opioid addiction is more complex than lawmakers, the Centers for Disease Control (CDC), and the media would have us believe.

Pressuring doctors who treat pain patients to prescribe fewer opioids may reduce the amount of opioids prescribed. While that doesn’t decrease the need for opioids, it may drive people who need pain medication to the streets to find relief.

Today, opioids are the only effective, affordable treatment for some chronic pain conditions. They certainly are an imperfect medication associated with significant risks for some patients. But they are the best tools doctors have for delivering compassionate treatment to many people with intractable pain.

People in pain who cannot receive the care they deserve are forced to choose between suffering, using unregulated drugs that they obtain illegally, or ending their own lives. This has been the unintended, albeit predictable, negative consequence of regulators’ current best efforts to solve the opioid crisis.

Francis Collins, Director of the National Institutes of Health (NIH), may emerge as a hero who helps find far more effective strategies for managing the opioid crisis. He recognizes that the opioid crisis, in part, is a pain crisis, and he understands that we will go a long way toward solving the opioid crisis when we find better solutions to the pain crisis.

You may recognize Collins (who has earned both an M.D. and a Ph.D.) as the director of the Human Genome Project. In a recent article, Mother Jones referred to him as a genius, and few would disagree.

Collins told Mother Jones reporter Julia Lurie, “The goal really needs to be to find nonaddictive but highly potent pain medicines that can replace the use of opioids given the terrible consequences that surround their use. This will be particularly important for people who have chronic pain, where we really don’t have effective treatments now.”

He is exactly correct with his analysis. The solution to the opioid crisis must include developing safer and more effective medication for pain. A small step forward would be for Congress to pass a law requiring all opioids to have abuse deterrent properties. Abuse deterrent formulations have been shown to cause a significant reduction in overdoses and rates of addiction. Passing such legislation would be analogous to the 1968 federal law, Title 49 of the United States Code, Chapter 301, Motor Vehicle Safety Standard that required all vehicles to be fitted with seat belts.

Mother Jones also reported, “At the Prescription Drug Abuse and Heroin Conference last month, Collins announced a public-private partnership, in which the NIH will collaborate with biomedical and pharmaceutical companies to develop solutions to the crisis.” This seems to be a rational and progressive decision. In Collins’ words, “While NIH can do a lot of the good science, and we can accelerate [it] if we have resources, we aren’t going to be the ones making pills. Many of the large-scale clinical trials are not done generally by us but by the drug companies. A successful outcome here—in terms of ultimately getting rid of opioids and the deaths that they cause—would not happen without full engagement by the private sector.”

Collins is saying what I would hope to hear from the NIH director, and I’m cautiously optimistic that he can be a part of the solution to the opioid crisis.

Unfortunately, the recent proposed budget from the Trump administration slashes funding for NIH and many of its important programs. Innovation in the field of pain and new therapies will require more, rather than less, funding.

Let’s hope the Trump administration sees the wisdom of Collins’ strategy and lets Pharma participate in finding the answers we need. Today, many people blame Pharma for the opioid crisis. But I’m convinced that it will take Pharma, in conjunction with the NIH, to solve the problem.




  1. Robin Pendergrast on May 28, 2017 at 1:00 pm

    I believe Dr. Collins does indeed have the correct idea…biomedical and Pharma have GOT to get on board…as does
    Trump. The increase in pain related suicides is frightening. NIH is with the resolution already. It just can’t be status
    quo. Dr. Collins along with others…Dr. Webster included…thoroughly understand the crisis.

  2. Kara on June 20, 2017 at 10:00 pm

    Personally, I doubt the increase in suicides among people in chronic pain was actually an “unforseen
    consenquence” as some other articles have called it, or even an “unintended” consenquence as mentioned here.

    When something is predictable than it is a foreseen consenquence and when it is not prevented it therefore becomes intended. Imho.

    I’m nearly certain it was absolutely expected. I also feel that those behind the unsubstantiated prescribing limits were well aware that people in pain would do anything to abate their suffering by any and all means – even by going outside of their moral code to accomplish it. In other words to the streets.

    When I read articles about the American occupation in Afghanistan and how our soldiers guard the poppy fields and how the fields have grown exponentially in size and number since the occupation while simultaneously heroin has seeped ubiquitously throughout our communities, I find it very difficult to believe that none of these consenquences were premeditated.

    • Kara on June 20, 2017 at 11:34 pm


      I meant to say at the end …

      “I find it very difficult to believe that these consenquences were *NOT premeditated.

      *sigh* darn auto “correct” on my ole phone.

      • deboruth on January 17, 2018 at 1:59 pm

        Can you cite references for “unforeseen” and “unintended” please? Long know pain increases probability of suicide. Last I saw was from something like 1.13 to 1.23 per……..have to look up the population incidence.

        Thank you.

  3. deboruth on January 17, 2018 at 1:55 pm

    Highly effective non-opiate pain substance from marine snails has been known and documented for at least 10 years. US pain doctors have paid no attention. Nor has government. Scientists in Philippines have been developing it. No one in entire US medical establishment has yet to take notice of it.

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