March 2024 Archive — FDA, Ketorolac (Toradol) and the Opioid Debate

This month we focused on one sharp question: did the FDA’s approval of Ketorolac (sold as Toradol) miss signals that helped fuel the opioid crisis? The piece you’ll find in this archive looks at how a non-narcotic drug entered common clinical use and why that raised alarms for some clinicians, reporters, and patient advocates.

Ketorolac is an NSAID — not an opioid. It reduces pain by blocking inflammation, unlike opioid painkillers that act on the brain’s reward system. But the controversy isn’t just about chemistry. It’s about how a powerful pain drug was approved, promoted, and prescribed in real care settings. The March article points out that approval focused on short-term safety and pain scores, while fewer questions were asked about how frequently it would be used outside controlled trials or combined with other drugs.

What critics raised in March

Investigators argued that the approval process did not fully consider real-world use. For example, Toradol’s strong pain relief made it attractive as a quick fix in emergency rooms and post-surgical care. That led to wider prescribing patterns than regulators may have anticipated. Critics worry this normalization of potent pain meds, even non-opioids, can change clinician habits and patient expectations — a subtle effect that may have eased the pathway to opioid overuse in other cases.

The article also highlights safety trade-offs. Ketorolac works well short-term but carries risks like stomach bleeding, kidney strain, and interactions with blood thinners. Those risks mean it isn’t a simple replacement for opioids; it’s a tool with its own downsides. The central concern raised in March: regulators and prescribers need to look past immediate pain scores and ask how approval and promotion change the bigger prescribing culture.

What you can do as a patient

If you’re facing a pain prescription, start with questions: Why this drug? How long should I take it? What are side effects and signs to stop? Ask if non-drug options were considered — ice, physical therapy, or lower-risk meds. If your provider recommends Ketorolac, confirm dosing limits and whether your other medicines or health conditions (like kidney problems or bleeding risks) make it unsafe.

Report problems. If you or someone you know has unexpected side effects or patterns of escalating prescriptions, file a report with FDA MedWatch and talk to your pharmacist. Policy change often starts with real-world reports that show patterns regulators didn’t catch in trials.

March 2024’s coverage isn’t a final verdict. It’s a call to pay closer attention to how drugs move from trials to everyday use. Approval matters, but so do prescribing habits, patient education, and follow-up. Keep asking questions — your safety depends on it.