Experts say painkiller guidelines 'too permissive'
The American Academy of Neurology (AAN), in an article in the journal Neurology, has proposed stricter guidelines for how doctors prescribe opioid painkillers, noting that for many chronic pain patients, the risk of dependence far outweighs the benefits.
This represents a significant change in the organization's position--in the late 1990s it had, under pressure from pain advocacy groups and pain specialists, agreed that the medications could be an effective long-term treatment for people with chronic, non-cancer pain, such as fibromyalgia and low back pain. That helped lead to numerous states dropping their bans on opioid painkillers being prescribed for longer than three months.
Those changes have been blamed for what's been described as a painkiller addiction" epidemic." More than 100,000 people have died from using prescribed opioid painkillers since the late 1990s.
The AAN now acknowledges that the more liberal attitude about the perceived safety of long-term opioid use occurred without clear scientific evidence that that was the case.
Among the new guidelines are recommendations that before prescribing opioid painkillers, doctors should screen patients for depression or any past drug use and use random urine drug testing. The AAN also recommended that doctors consult a pain management specialist if dosage exceeds a morphine-equivalent dose of 80-120 mg per day.