The current issue of The Journal of Pain has published a guideline to assist clinicians in prescribing opioid pain medications for patients experiencing chronic non-cancer pain.
“To create this guideline, researchers in the Oregon Evidence-based Practice Center (EPC) at Oregon Health & Science University collaborated with the APS and AAPM for two years, reviewing more than 8,000 published abstracts and nonpublished studies to assess clinical evidence on which the new recommendations are based”.
An extensive literature review revealed that much research is needed in this area; however conclusive evidence suggests that opioids are safe and effective for certain patients, if carefully monitored.
The guideline consists of 25 recommendations, some of which consider the growing concerns for opioid abuse and addiction. Opioids, such as oxycontin and morphine, have gradually become more commonly prescribed and accepted for treating various sorts of pain, including chronic low-back pain, arthritis, fibromyalgia etc., whereas previously opioids were mainly used for treating pain related to post-op, cancer and death.
This new guideline insists that clinicians rule out other possible medications as treatment options before prescribing opioids. However, if it is determined that opioid medication is the ideal choice, clinicians are expected to “conduct a thorough medical history and examination and assess potential risk for substance abuse, misuse or addiction”.
It is shocking to learn that this hasn’t already been considered common practice and that a guideline had to be introduced in order to put this in place! It’s no wonder there has been such an increase in opioid abuse and misuse. Seriously, is this not a typical task for a medical doctor? It seems like a fairly important step in any type of treatment.
Subsequently, with this guideline it will ensure that clinicians “continuously assess patients on chronic opioid therapy by monitoring pain intensity, level of functioning and adherence to prescribed treatments. Periodic drug screens should be ordered for patients at risk for aberrant drug behavior”.
The American Pain Society and the American Academy of Pain Medicine have ensured that patients will be well monitored. To read more about other recommendations in this guideline regarding such topics as methadone use, high dosages, abusers, pregnancy, driving safety, and more, please view the following article: New Guideline For Prescribing Opioid Pain Drugs.