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ISSUE: MARCH 2013 | VOLUME: 40
Pain Group Says Simple Dosing Change Won't Fix Prescription Drug Abuse Problem
by PPN Staff
Changing the label on opioid pain medications to limit their continuous use to 90 days would do little to stop drug abuse while depriving millions of Americans of the medication they need to live a reasonable life, according to a leading professional organization representing pain specialists.
In written comments to the FDA, the American Academy of Pain Medicine (AAPM) renewed its commitment to fighting prescription drug abuse but warned that adopting the proposal could effectively eliminate the use of opioids for chronic noncancer pain, usually defined as pain lasting longer than 90 days.
“This position could potentially leave an untold number of pain sufferers with few treatment options, given the on-label restrictions imposed by many insurers, including Medicare/Medicaid,” AAPM leadership wrote.
In light of the complexities surrounding this and other proposed labeling changes, the FDA held a public hearing in March to consider the science behind the safety and effectiveness of administering opioids for chronic noncancer pain. A decision on labeling has yet to be made.
The Institute of Medicine (IOM) reports that 100 million Americans live with chronic pain. Chronic opioid therapy may not be a first choice for the control of pain but can effective for some patients who don’t respond to other therapies and who would otherwise suffer terribly, according to the AAPM.
Other proposals under consideration by the FDA include limiting long-term opioid therapy to severe pain (excluding moderate pain) and setting a daily dosage limit of 100 mg morphine equivalents. The AAPM stated that there is evidence supporting that patients vary widely in their experience of pain and their response to medications, in part because of genetic differences. The group called the 100-mg limit “unsubstantiated” and expressed fear that a sole focus on dose could lull prescribers into a false sense of security by allowing them to ignore important risk factors.
Based on a press release from the American Academy of Pain Medicine