Opioid Tapering: Safely Discontinuing Opioid Analgesics
Severe hurricanes in the Gulf Coast during 2005 caused many hardships for patients and healthcare providers alike. An important concern coming to light during this time of crisis was the inability to obtain prescription medications, including opioid analgesics. Patients with chronic pain and their healthcare providers faced the daunting task of either somehow procuring the More Info »
Commonsense Oxycodone Prescribing & Safety
Oxycodone is FDA-approved for treating moderate to severe pain that is either acute or chronic in nature. It has been widely used in pain management practice for decades but has recently been receiving much negative attention due to abuse, overdose, and deaths associated with the controlled-release formulation. So, in the overall approach to pain management, More Info »
Opioid Safety in Patients With Renal or Hepatic Dysfunction
It has been estimated that up to one-third of patients with renal dysfunction (defined as creatinine clearance [CrCl] < 50 mL/min) also receive opioids to relieve pain [Davison 2003]. Use of opioids in these patients can present a challenge because adequate pain control is necessary while balancing the risk of overdose due to altered drug More Info »
Managing Opioid-Induced Constipation
Constipation is a frequent side effect of opioids since these agents decrease peristaltic activity in the gastrointestinal (GI) tract. Because of the mechanisms involved in opioid-induced constipation, some treatments that may be applicable for common, functional constipation are inappropriate for ambulatory-care patients prescribed opioid analgesics. Also in these patients, the distress of constipation may add More Info »
PAINS Policy Brief #4: Opioid Treatment Agreements or “Contracts”
Pain care in the United States presents a complex set of challenges. On the one hand, there is ample documentation that pain, especially chronic pain, is often not well managed, and that as the Institute of Medicine has stated, we need a “cultural transformation in how pain is judged, managed and treated” to advance pain More Info »
PAINS Policy Brief #3 Summary: Pain & Policy Studies Group Report Card
Summary for policy brief List of current legislative barriers for each state This policy brief is a product of the Pain Action Alliance to Implement a National Strategy (PAINS), in collaboration with the Center for Practical Bioethics, the American Academy of Pain Management (AAPM), and the Pain and Policy Studies Group (PPSG) at the University More Info »
PAINS Policy Brief #3: Pain & Policy Studies Group Report Card
Healthcare practice, including pain management, is governed at the state level and not by federal laws. Numerous barriers continue to affect the provision of pain care. A prevalent barrier is the presence of state policies that create undue restrictions or practice ambiguities. Healthcare professionals need to understand the state statutes and regulatory policies that govern More Info »
PAINS Policy Brief #2 Summary: Prescription Monitoring Programs
Despite wide agreement that prescription monitoring programs (PMPs) can be valuable healthcare delivery tools and extremely effective at preventing “doctor shopping,” PMPs remain under-utilized, with most states reporting approximately one-third or fewer of authorized prescribers and dispensers using them. Undoubtedly, one of the most important policy needs around PMPs involves ways to promote widespread, even More Info »
PAINS Policy Brief #2: Prescription Monitoring Programs
Prescription monitoring programs (PMPs, also known as prescription drug monitoring programs, or PDMPs) are state-operated databases that collect, store, and distribute information about controlled substance prescriptions. The specific characteristics of these programs (e.g., which controlled substance schedules are included, who can access the data, which agency runs the program, etc.) can vary from state to More Info »
PAINS Policy Brief #1: Impact of State Policy and Regulation on Those Living with Chronic Pain
Pain is one of the most devastating public health problems affecting Americans today. In 2011, the Institute of Medicine (IOM) published Relieving Pain in America: a Blueprint for Transforming Prevention, Care, Education and Research, articulating the magnitude of this issue. Not including children, veterans and those who are institutionalized, the IOM reported that at least More Info »