Recently, a group of 37 physicians petitioned the FDA to withdraw approval for the use of opioids for patients with moderate, non-cancer pain. This petition, which was filed by Physicians for Responsible Opioid Prescribing and the Washington-based group Public Citizen, wants the FDA to make the following changes regarding opioid prescriptions:
- Strike the term "moderate" as an indication for non-cancer pain
- Limit the maximum daily dose to the morphine equivalent of 100 mg per day for non-cancer-pain
- Limit the daily use of opioids for non-cancer pain to 90 days
These groups feel the modifications they're requesting will reduce problems caused by chronic narcotic use, such as the diversion and harm that can occur with using narcotics to treat moderate, non-cancer pain.
The FDA has one year to respond to the request.
Some pain-management physicians are not in favor of these restrictions. Dr. James Cleary, director of the University of Wisconsin's Pain and Policy Studies Group, states that there has been no evidence presented to support these changes. He feels such changes would not only be harmful to patients, but immoral.
The American Academy of Pain Medicine agrees with Dr. Cleary, stating: "We believe that [the petitioners'] recommendations for reducing the dosage and duration of prescribed medications fail to take into account the needs of the millions of Americans who are finding relief from the debilitating effects of chronic pain thanks to a long-term care plan that includes the use of appropriately prescribed opioids."
To read the complete article, "Are Opioids Only for Patients With 'Severe Pain'?", visit the AMA Association's Website.
I think the restrictions proposed by Physicians for Responsible Opioid Prescribing are too harsh. I've seen many people benefit from a pain-management regimen that included opioids.
How do you feel about restricting narcotics for non-cancer pain?
- Petition seeking change in FDA labeling for opioid analgesics, Physicians for Responsible Opioid Prescribing, July 25. Available at www.citizen.org/documents/2048.pdf.
- "Frequency of Prescription Pain Reliever Nonmedical Use: 2002-2003 and 2009-2010," Archives of Internal Medicine, published online June 25. Available at archinte.jamanetwork.com/article.aspx?doi=10.1001/archinternmed.2012.2533.
- "Curbing the Opioid Epidemic in the United States," The Journal of the American Medical Association, Aug. 1. Available at jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.8165.
- "Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain," Journal of Pain, February 2009. Available at http://www.ncbi.nlm.nih.gov/pubmed/19187889/.