AAFP Outlines Strategy to Prevent Opioid Prescription Drug Abuse
August 6, 2012 - The American Academy of Family Physicians has developed a broad plan to promote practices that will help counter the nation’s opioid abuse epidemic while still allowing for the viable and effective treatment of pain.
The AAFP is committed to working actively toward a solution to America’s pain management and opioid abuse epidemics through advocacy, collaboration and education. A formal position paper, outlining the AAFP’s strategies toward countering opioid abuse and improving pain management, can be found here.
Among the recommendations detailed in the position paper are the following:
- The AAFP opposes any action that limits patients' access to physician-prescribed pharmaceuticals;
- The AAFP urges family physicians to individualize and monitor therapy based upon review of the patient’s potential risks and benefits;
- The AAFP supports development of evidence-based provider education to ensure the safest and most effective use of long-acting and extended-release opioids;
- And the AAFP urges all states to implement prescription drug monitoring programs and the interstate exchange of registry information as called for under the National All Schedules Prescription Electronic Reporting Act of 2005.
“The AAFP takes the prevalence and perils of prescription drug abuse very seriously,” said Glen Stream, MD, MBI, president of the AAFP. “This is a public health crisis, and we are obligated to help equip our members with the knowledge, skills and resources needed to provide their patients appropriate and adequate pain management.”
An estimated 60 million Americans have some type of chronic, nonmalignant pain, representing a substantial public health issue with tremendous economic, social and medical costs. The annual cost associated with all types of pain is estimated to be in the range of $560 to $635 billion in the United States.
A growing percentage of the U.S. population utilizes opioid analgesics for pain control. Unfortunately, growth in proper prescribed use has been accompanied by a corresponding growth in the rate of abuse, misuse, and overdose of these drugs.
However, 40 percent of patients with chronic pain do not achieve adequate pain relief.
Family physicians and other primary care clinicians play a vital role in effective pain management, including the prescribing of opioid analgesics. The creation of additional prescribing barriers for primary care physicians would limit patient access when there is a legitimate need for pain relief.
As such, the AAFP opposes any action that limits patients' access to physician-prescribed pharmaceuticals, and opposes any actions by pharmaceutical companies, public or private health insurers, legislation, the FDA or any other agency, which may have the effect of limiting by specialty the use of any pharmaceutical product.
“The vast majority of patients with chronic pain turn to their primary care physicians for relief. Pain management is very personal and challenging, and physicians should have a full range of options to choose from in order to tailor treatments to suit each individual patient,” Stream said.
In its position paper, “Pain Management and Opioid Abuse: A Public Health Concern,” the AAFP has concluded that the goal of pain management should be primarily improvement and maintenance of function. The AAFP urges family physicians to individualize therapy based upon review of the patient’s potential risks, benefits, side effects, and functional assessments, and to monitor ongoing therapy accordingly.
Successful treatment demands the latest science. The AAFP supports development of evidence-based provider education to ensure the safest and most effective use of long-acting and extended-release opioids, and risk evaluation and mitigation strategy (REMS) on opioid abuse. The AAFP is working with the Food and Drug Administration and pharmaceutical companies to develop educational opportunities on safely prescribing of opioid analgesics that best supports learners’ needs.
“We will strongly advocate for increased national funding to support research into evidence-based strategies for pain management. We also call for financial support to incorporate these findings into the patient-centered medical home model and for payers to recognize the time and efforts required for proper patient assessments and treatments,” Stream said.
The AAFP recognizes that long-acting and extended-release opioids are powerful drugs that require oversight, but these drugs can be controlled without unduly limiting their proper use. Many states have started their own efforts to control misuse through model medical board prescribing policies, prescription monitoring programs and other measures.
The AAFP urges all states to implement prescription drug monitoring programs and the interstate exchange of registry information as called for under the National All Schedules Prescription Electronic Reporting Act of 2005.
“When considering pain management regulation and legislation, states should obtain physician input,” Stream said.
Beyond educating its member physicians, the AAFP will work to educate the public on safe and responsible drug use through its patient-oriented website, FamilyDoctor.org and other oportunities.
“The AAFP is confident that family physicians can help reduce the grim harms of opioid abuse, without limiting their ability to treat their patients’ pain and help maintain their quality of life,” Stream said.