Philip,

The issue of opiophobia is inversely connected to the pairing of acetaminophen
and opiates...opiophobia is what coupled the two drug classes together in the
first place.

There is a patient-driven movement in the USA towards overcoming that doctors'
opiophobia, and many medical bodies are coming to support that movement.
decoupling acetaminophen and opiates makes that easier, because the combination
of the two is simply one of the biggest (or the biggest, depending on the
information source) causes of drug overdoses in the US.

ALL press coverage of the FDA panel decision has focused on the danger involved
being from acetaminophen, not from any opiate. This can only help the cause of
the pain-management movement, as even the most disconnected doctors learn that
the FDA is not as concerned with opiates as they feared. More so now that we
have a rational Executive in place.

I dont know what the over-the-counter drug market looks like in the UK, but here
in the US one can find acetaminophen everywhere and in almost everything.
However, as a result of opiophobia, overdoses and fatalities that should have
been attributed to (prescribed and non-prescribed) acetaminophen were attributed
to prescribed opiates instead.

As you yourself point out, opiates have an exceptionally wide therapeutic
range...but acetaminophen has an exceptionally narrow range. the horridly
paternalistic attitude that paired them together in the first place (expressly
to punish "unauthorized" opiate use) has destroyed tens or hundreds of thousands
of livers and lives pointlessly, and ironically exacerbated the opiophobia that
leaves many in needless agony.

decoupling them has been a long time coming, and will ultimately benefit
patients medically...and politically.

Jeton
********
I suffer from a congenital connective tissue disorder called Marfan syndrome.
This syndrome is caused by a faulty gene (FBN1) on the 15th chromosome pair, and
is autosomal dominant (if one parent has the syndrome, each child that the
parent brings into the world stands a 50% chance of presenting with this
syndrome). The fault in FBN1 causes this gene to code for a damaged version of
a key protein called fibrillin-1 (this protein is a key component of connective
tissue).