To reverse a still-spiraling American crisis fueled by prescription narcotic drugs, a panel of experts advising the federal government has recommended sweeping changes in the ways that physicians treat pain, their patients cope with pain, and government and private insurers support the care of people living with chronic pain.

In a comprehensive report on what must be done to staunch the toll of opiates in the United States, a panel of the National Academies of Science, Engineering and Medicine makes clear that steps needed to prevent the creation of future opiate addicts will drive some people who are now dependent on these medications toward street drugs such as fentanyl and heroin.

“It is therefore ethically imperative to couple a strategy for reducing lawful access to opioids with an investment in treatment for the millions of individuals” already hooked on the painkillers, the panel wrote.

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