Striking a Balance with Pain Management

In an unprecedented collaboration, the US Drug Enforcement Administration (DEA) and 21 of the nation's leading pain and healthcare organizations have come together to call for a balanced policy governing prescription pain medications such as OxyContin.

During a press conference announcing the collaboration, DEA Administrator Asa Hutchinson urged a policy that protects the appropriate use of opioid pain relievers for patients who need them while also preventing abuse and diversion of the drugs.

Hutchinson stood with groups representing physicians, nurses, pharmacists and patient advocates to release a consensus statement on prescription pain medications such as OxyContin, an opioid that has received wide attention as a new drug of choice by substance abusers.

Opioid analgesics are a class of natural and synthetic medication that relieves moderate to severe pain. The joint statement noted that for many patients these drugs offer the most effective way to treat their pain, and they are often the only option that provides significant relief.

Because opioids are one of several types of controlled substances that have potential for abuse, they are carefully regulated by the DEA and other state agencies. For example, a physician must be licensed by State medical authorities and registered with the DEA before prescribing a controlled substance.

"Healthcare professionals, law enforcement and regulatory personnel share a responsibility for ensuring that prescription pain medications are available to the patients who need them, and for preventing these drugs from becoming a source of harm or abuse," the joint statement said.

"We don't want to cause patients who have legitimate needs for these medications to be discouraged or afraid to use them. And we don't want to restrict doctors and pharmacists from providing these medications when appropriate," Hutchinson said.

"At the same time, we must all take reasonable steps to ensure that these powerful medications don't end up in the wrong hands and lead to abuse. We want a balanced approach that addresses the abuse problem without keeping patients from getting the care they need and deserve."

"The repeated accounts of misuse have skewed peoples' perceptions about drugs like OxyContin," added Dr. Russell Portenoy, chairman of pain medicine and palliative care at Beth Israel Medical Center in New York City. "The reality is that the vast majority of people who are given these medications by doctors will not become addicted."

Unfortunately, Portenoy added, "some doctors may now be frightened to prescribe these medications, pharmacists may be reluctant to stock them, and patients may refuse to take them because of fear of addiction and the new social stigma."

The DEA and healthcare groups also called for a renewed focus on educating health professionals, law enforcement, and the public about the appropriate use of opioid pain medications in order to promote both responsible prescribing practices and limit instances of abuse and diversion.

SOURCES:
Press Conference, U.S. Drug Enforcement Agency, October 23, 2001, Washington, DC
U.S. Drug Enforcement Agency (http://www.usdoj.gov/dea) SOURCE:
University of Michigan Comprehensive Cancer Center (http://www.cancer.med.umich.edu)

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