Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act

A Joint Statement From 21 Health Organizations and the Drug Enforcement Administration

As representatives of the health care community and law enforcement, we are working together to prevent abuse of prescription pain medications while ensuring that they remain available for patients in need.

Both healthcare professionals, and law enforcement and regulatory personnel, share a responsibility for ensuring that prescription pain medications are available to the patients who need them and for preventing these drugs from becoming a source of harm or abuse. We all must ensure that accurate information about both the legitimate use and the abuse of prescription pain medications is made available. The roles of both health professionals and law enforcement personnel in maintaining this essential balance between patient care and diversion prevention are critical.

Preventing drug abuse is an important societal goal, but there is consensus, by law enforcement agencies, health care practitioners, and patient advocates alike, that it should not hinder patients� ability to receive the care they need and deserve.

This consensus statement is necessary based on the following facts:

• Undertreatment of pain is a serious problem in the United States, including pain among patients with chronic conditions and those who are critically ill or near death.
• Effective pain management is an integral and important aspect of quality medical care, and pain should be treated aggressively.
• For many patients, opioid analgesics—when used as recommended by established pain management guidelines—are the most effective way to treat their pain, and often the only treatment option that provides significant relief.
• Because opioids are one of several types of controlled substances that have potential for abuse, they are carefully regulated by the Drug Enforcement Administration and other state agencies. For example, a physician must be licensed by State medical authorities and registered with the DEA before prescribing a controlled substance.
• In spite of regulatory controls, drug abusers obtain these and other prescription medications by diverting them from legitimate channels in several ways, including fraud, theft, forged prescriptions, and via unscrupulous health professionals.

Drug abuse is a serious problem. Those who legally manufacture, distribute, prescribe and dispense controlled substances must be mindful of and have respect for their inherent abuse potential. Focusing only on the abuse potential of a drug, however, could erroneously lead to the conclusion that these medications should be avoided when medically indicated—generating a sense of fear rather than respect for their legitimate properties. Helping doctors, nurses, pharmacists, other healthcare professionals, law enforcement personnel and the general public become more aware of both the use and abuse of pain medications will enable all of us to make proper and wise decisions regarding the treatment of pain.

American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Pain Medicine
American Alliance of Cancer Pain Initiatives
American Cancer Society
American Medical Association
American Pain Foundation
American Pain Society
American Pharmaceutical Association
American Society of Anesthesiologists
American Society of Law, Medicine & Ethics
American Society of Pain Management Nurses
American Society of Regional Anesthesia and Pain Medicine
Community-State Partnerships to Improve End-of-Life Care
Drug Enforcement Administration
Last Acts
Midwest Bioethics Center
National Academy of Elder Law Attorneys
National Hospice and Palliative Care Organization
Oncology Nursing Society
Partnership for Caring, Inc.
University of Wisconsin Pain & Policy Studies Group