Opioids, pain management and the law.
OBJECTIVE
Approximately 100 million people suffer from chronic pain in the USA. Opioid medications are commonly prescribed to treat pain, but are becoming the most widely misused controlled substance nationally. Physicians who treat patients with chronic pain must be cognizant of the federal and state policies that govern the distribution of opioid medications as well as the current standards of medical practice for opioid prescribing.


RESULTS
The laws and policies regarding the standard medical practice for opioid prescribing are constantly subject to revision. The National Drug Control Policy announced its plan to fight prescription drug abuse in 2011 and unveiled the Risk Evaluation and Management Strategy initiative. Currently there is a Risk Evaluation and Management Strategy for Transmucosal Immediate-Release Fentanyl. Other resources, such as state-run prescription drug monitoring programs, are also available to many physicians. The level of participation in these programs by physicians and pharmacists varies by state, and funding for continuation of these programs is an ongoing issue.


CONCLUSIONS
The problems of undertreated pain and the epidemic of prescription drug abuse have coincided, creating a need for medical and social policy that protects society and access to appropriate care for those in pain. Federal and state laws are in evolution, and clinicians must remain aware of these changes as well as the issues behind them that will impact safe and appropriate care of patients in pain.
Division of Pain Medicine, Department of Anesthesiology, University of California, Davis School of Medicine, California 95817, USA.
R Scott
RS
Stayner
David J
DJ
Copenhaver
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D011307:Drug Prescriptions; D006801:Humans; D035846:Law Enforcement; D007883:Legislation, Medical; D009293:Opioid-Related Disorders; D059408:Pain Management / Q000379:methods*; D018570:Risk Assessment; D014481:United States; D014486:United States Food and Drug Administration
D000701:Analgesics, Opioid