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Medical devices could help combat the opioid crisis

Medical devices that target pain, identify patients at risk for developing opioid use disorder and limit diversion from treatment have the potential to help combat the opioid epidemic, according to a viewpoint published in JAMA Psychiatry.

Unlike the drug approval process, which requires substantial evidence, the process for medical devices is based on “reasonable assurance of safety and effectiveness,” according to Sandra D. Comer, PhD, from the department of psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, and colleagues.

In April 2018, a meeting occurred where experts discussed ways that medical devices could be used to prevent opioid use disorder, Comer and colleagues wrote. At this meeting, three target areas were identified for the development of such devices:

• opioid sparing/replacing devices that target pain treatment;
• devices that identify patients with pain at risk for developing opioid use disorder; and
• devices that lower the risk for diverting or misusing prescribed opioids.

The researchers explained that an opioid sparing or replacing device could potentially have a “direct pain-relieving effect, work synergistically with opioids, or target symptoms of opioid withdrawal, thereby allowing an easier tapering from an opioid.” Deep-brain stimulation, transcranial-magnetic stimulation and types of spinal cord stimulation are currently under development for this purpose, according to Comer and colleagues.

Devices that can identify patients who are at risk of developing opioid use disorder include urine drug tests, those that monitor compliance with drug ingestion, smartphone-based apps and genetic tests, the researchers wrote. In addition, the development of medical devices that ensure medication bottles only open when a patient applies their own fingerprint may be a way to decrease the diversion of opioids.

Comer and colleagues noted that although there are barriers associated with each of these target areas, the development of devices to prevent opioid use disorder represents a vital step in addressing the opioid epidemic.

“While multiple approaches are needed to address the opioid crisis in the United States, simply restricting or limiting access to treatments for pain runs the risk of increasing patient distress,” they wrote. “Novel approaches for addressing pain and opioid use are critically needed, and the three target areas described in this article represent an important component of the overall national strategy to address this public health emergency.” – by Savannah Demko

Disclosure: Please see the study for a list of the authors’ relevant financial disclosures.