Just a quick note– A group of researchers from Boston University School of Medicine weigh in on the issue of opioid prescribing in an online editorial available through this link.  The editorial appears in the Journal of General Internal Medicine, and I do not know how long the link will be active.  All such articles are copyright-protected, keeping me from posting them here– but the link operational for non-subscribers, at least for now.

In short, the editorial calls for several measures for patients prescribed chronic opioids, including monitoring for abuse, greater education, and creation of databases to prevent over-prescribing, doctor shopping, etc.

Thank you to everyone who chimed in with opinions about the PROP letter.  I shared the comments with the people at PROP, and those who read the comments saw an interesting exchange between the a couple of physicians from that group and a physician from pain-topics.org.  Hopefully the letter and comments– along with the other articles I’ve highlighted– will help provide an understanding of the current debate over using opioids for chronic pain.

Backache photo available from Shutterstock.

I’ve written about the spectrum of medical and scientific opinion (not, unfortunately, always the same thing) over the use of opioids for treatment of chronic pain.  For those who missed the earlier discussion– one that produced a heated response from readers– I invite you to review those posts.

The essence of the issue is that over many years, there has been significant effort to increase patient access to potent opioids.  This effort has come in part from the pharmaceutical industry, but also from organizations that advocate for patients with a wide range of painful conditions, some with connections to pharma, and some without connections to pharma.

There has even been a push to increase opioid prescribing from Federal agencies.  Back in the 1990′s, when I chaired my local hospital’s Department of Anesthesia, we were warned by agencies hired by the hospital that the Joint Commision on Accreditation was focusing on pain control one particular year, and that some hospitals had been cited for insufficient prescribing of pain medications.