Opiod prescribtions have been abused by millioms of people in America and the Health industry has to be able to find a balance of how to distrubute pain killers to consumers. “In recent decades, the United States has seen a dramatic increase in opioid prescribing for chronic pain. That growth has been associated with increasing misuse of these medications, leading to alarming increases in unintentional opioid overdose deaths.
In a perspective in this week’s New England Journal of Medicine, Daniel Alford, MD, MPH, associate professor of medicine and assistant dean of Continuing Medical Education and director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program at Boston University School of Medicine (BUSM), recommends that prescriber education is the best approach to addressing the prescription opioid-misuse epidemic, allowing for individualized care on the basis of a patient’s needs after a careful benefit-risk assessment.
According to Alford, a key problem is that clinician education around pain management and safe opioid prescribing has been lacking. As opposed to blunt regulatory solutions that decrease access to opioids in an indiscriminant way, education is a more finely tuned approach that can empower clinicians to make appropriate, well-informed treatment decisions for every patient at each clinical encounter. “Education has the potential to both reduce overprescribing and ensure that patients in need retain access to opioids,” explained Alford, who is also medical director of Boston Medical Center’s Office-based Opioid Treatment (OBOT) program.
Alford points out clinicians have limited tools at their disposal to help patients with severe chronic pain and the reimbursement system favors the use of medications alone, despite evidence supporting multimodal pain management. Moreover, whereas clinicians can use objective measures to guide their management of other chronic diseases, here they must rely solely on the patient’s (or family’s) reports of benefits (such as improved function) and harms (such as loss of control).”
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