Patient Advocacy Group Offers Opioid Prescribing Recommendations – June 13, 2018 – By Richard A. Lawhern, PhD and Steven E. Nadeau, MD
I’m proud that the advocacy group I’m involved with (ATIP) has its recommendations published in this mainstream medical magazine:
Advocacy group describes why CDC Guidelines on Opioid Prescribing should be withdrawn and rewritten.
In a whitepaper titled “Principles for Patient-Centered Opioid Prescription Guidelines,”* the Alliance for the Treatment of Intractable Pain [ATIP] argues that the CDC Guidelines for Prescribing Opioids for Chronic Pain “must be withdrawn and rewritten” to recognize both the indispensable role that opioids play in chronic pain management, and the central role of physicians in assessing and prescribing medications as patients require.
1. Doctors must be free to prescribe both opioid and non-opioid analgesics
2. Patients must be evaluated and treated for post-surgical pain as individuals, informed by guidance on best practices.
3. There is a need to better train general practitioners to recognize and distinguish between indications of problematic opioid use versus emergence of chronic pain due to failed surgery.
The healthcare “system” fails to acknowledge incidents, where surgery was done to relieve pain-generating problems, can sometimes not only fail to fix the original problem but then also add even more pain from the “Failed Back Surgery Syndrome” (an official diagnosis).
4. The US Drug Enforcement Administration has recommended further reduction of production quotas for scheduled drugs found to be “subject to diversion.” However, prescribing levels are presently at a 10-year low and hospitals across the country are experiencing shortages of opioid analgesics needed in surgery.
The DEA should end these restrictions.
These restrictions on legal opioids have resulted in opioid shortages in hospitals everywhere:
- DEA Quotas Cause Opioid Shortage in Hospitals
- Opioid Shortages Force Improvisation
- Opioid epidemic or opioid shortage?
- 5 unintended consequences of addressing the opioid crisis
5. The significance of “relative risk” of untoward outcomes versus opioid dose level should be evaluated in the context of absolute risk.
…overall risk of overdose death across all dose levels was on the order of 0.05% or lower.
* An early version of this paper, now available at https://atipusa.org/2018/04/02/atip-white-paper-on-prescription-opioids-and-chronic-pain/ and including full references, was published in April 2017 by National Pain Report and The Journal of Medicine of the US National College of Physicians, and featured by Pain Week under the title “What if Prescribing Guidelines Were Patient Centered?” The opinions presented herein do not represent those of the VA, federal government, or authors’ affiliated organizations.