Pain care and opioid-use disorder are focus of new efforts

Sara Berg
Senior Staff Writer
AMA Wire
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Pain is a tremendous burden on the American public, especially chronic pain, which affects about 100 million Americans, according to a 2011 Institute of Medicine report. With such a high burden on the American public, the AMA House of Delegates (HOD) took actions aimed at improving pain care while expanding access to buprenorphine for patients with opioid-use disorder and encouraging the safe storage and disposal of controlled substances.

A resolution presented by the American Academy of Pain Medicine argued that “an imbalance remains regarding the attention paid by governmental and regulatory agencies toward the appropriate treatment of chronic pain in light of the risks of opioid addiction” and that “ample evidence-based research shows the success of a multidisciplinary pain management program in treating chronic pain, which does not rely heavily on opioids.”

To ensure that pain care gets the attention it deserves amid the vital effort to address the opioid epidemic, delegates directed the AMA to convene a task force from organized medicine to:

  • Discuss medicine’s response to the public health crisis of undertreated and mistreated pain
  • Explore and make recommendations for augmenting medical education designed to educate healthcare providers on how to help patients suffering from pain with evidence-based treatment options
  • Discuss strategies that may prevent or mitigate acute pain, educate physicians about these strategies, and suggest research to study if these strategies prevent the development of chronic pain

Delegates agreed that the task force should include primary care, surgical and other medical specialties that are involved in providing pain care.

In separate actions, delegates asked the AMA Opioid Task Force to continue its work to reduce opioid-related harm by:

  • Continuing to educate all prescribers on the importance of optimal use of opioids” including appropriately limiting the quantities of opioid prescriptions and advocating electronic prescription capabilities for controlled substances.
  • Publicizing existing resources that provide advice on overcoming barriers and implementing solutions for prescribing buprenorphine for treatment of opioid-use disorder.
  • Continuing to adapt current educational materials to distribute to prescribers and patients emphasizing the importance of safe storage and disposal of opioids.
  • Encouraging prescribers to work with local organizations and pharmacists to develop and disseminate the most up-to-date information on local drug take-back events while working with patients to seek more such programs.

Support for harm-reduction pilot

In an action aimed at reducing the harms associated with illicit drug use, the HOD voted to support pilot supervised injection facilities. Such facilities can cut the number of overdose deaths, lower infectious-disease transmission rates and increase the number of people who seek treatment for substance-use disorders, according to research conducted outside the U.S.

“State and local governments around the nation are currently involved in exploratory efforts to create supervised injection facilities to help reduce public health and societal impacts of illegal drug use,” Patrice A. Harris, MD, said in a statement. She is chair of the AMA Board of Trustees and also chairs the AMA Opioid Task Force.

“Pilot facilities will help inform U.S. policymakers on the feasibility, effectiveness and legal aspects of supervised injection facilities in reducing harms and health care costs associated with injection drug use,” Dr. Harris said.

In its deliberations, the HOD relied greatly on the Massachusetts Medical Society, which in April released a comprehensive report on the medical literature related to supervised injection facilities.

Read more news coverage from the 2017 AMA Annual Meeting.

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Comments

These recommedations are wonderful but totally impractical. The big Pharms are making money. Answer - classify as a "1" drug - no more prescriptions and find alternate, less harmful ways to treat these addictions. Similar to gasoline, the gas companies in conjunction with auto makers, created gas guzzling cars, now the prices have come way down, because other forms are available and rules put in place to make cars more fuel efficient. The technology was always there, just not released.
What these Government agencies are doing is fighting chronic pain disease patients. We use legitimate prescription medications for diseases. The crisis is that they are targeting CHRONIC PAIN PATIENTS. Chronic pain is now the epidemic. We are being caterogized and descriminated against for a medication we require to reduce our pain. No other chronic disease patient is targeted for their use of a prescription medication. What about the good of opioid medications. They are lifesaving medications for millions of Americans who live in constant, debilitating, chronic pain. Though the number of prescribed opioids are down, the overdose deaths are "reportedly, at an all time high". So this system is not working. When a death does occur, there is no specific testing as to what opioid drugs attibuted to the death. Whether there were other drugs or alcohol in the system, or whether the specific "medication" was for that individual, was it illegally manufactured heroin, fentynal or carfentynal. The misuse of medication by legitimate chronic pain disease patients is .02-.6 %. It is use of illegal opioids and misuse of legal opioid medications that lead to abuse by citizens. The FDA, DEA, CDC and all other Government agencies need to go after the illegal fentynal and heroin producers and manufacturers, also, methamphetamine, cocaine and all other illegal drugs. Addicts will always have the illegal drugs and find a way to get them. Why is it that our physicians are no longer able to Doctor us? Why is it that these agencies can now Doctor us and practice medicine without a medical license? What has happened to Doctor/patient confidentiality. It no longer excists. Pharmacists, insurance companies and these Government agencies are now able to decide what us patients actually need when it comes to our medications. They are policing our physicians. I believe it is up to our physicians to treat us adequately and humanely with medication, so many of us desperately need, for our disease. This targeting is wrong! It is discrimination against legitimate chronic pain disease patients who use our MEDICATION responsibly. Addicts will find and use the illegal drugs of their choice. We pain disease patients are not addicts, we are PATIENTS, with incurable diseases. Medications are readily available to us for our conditions, that happens to fall into the same category as the illegal drugs.
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Nov 16, 2017
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