Trauma, surgery, and cancer treatment can lead to chronic pain. Sometimes the most effective way to control that pain is through the use of potentially addictive agents. This is an appropriate use of narcotics. But it must be managed carefully.

The real problem in our society is the large number of people who do not have a legitimate medical need. They use and abuse alcohol and other drugs for the effects these drugs provide. The risk of addiction is much greater in these individuals compared with medical patients who do not have a lifetime history of problems with substance abuse.

There is an effort underway to develop opioid abuse-deterrent products. Such a drug would allow for the management of chronic pain but patients would remain abuse resistant. The challenges facing drug companies in this research effort are wide-ranging.

According to experts in the field, opioid abuse-deterrent formulations will eventually be made available. Research and development using human subjects in trials with narcotic agents takes time. Finding a product that deters one type of abuse may not work for others. It's likely that more than one drug will have to be developed.

The Food and Drug Administration will play a key role in deciding how these products can be marketed and advertised. Guidelines will have to be developed for monitoring the use of such products. We may be several years away from a workable solution to this problem.