Concern about potential addiction and drug abuse has resulted in widespread inadequate use of opioids for pain relief, including for terminally ill patients.
To bring state regulatory policies more in line with medically appropriate prescribing of opioid analgesics for pain management, between 1997 and 1999 the Pain & Policy Studies Group of the University of Wisconsin-Madison Medical School conducted surveys and held meetings with health care professionals.
Project staff also evaluated opioid abuse compared to medical opioid use; and assessed state medical board guidelines and state laws and regulations related to pharmacy and nursing practice.
The project investigators reported major findings in several journals, including Journal of Pain and Symptom Management and the Journal of the American Medical Association. Findings included:
- Although the medical use of opioid analgesics increased between 1990 and 1996, abuse of these drugs decreased over the same period.
- Medical board members surveyed in 1997 were more accepting than those surveyed in 1991 of the legality of extended opioid prescribing for patients with chronic pain and more knowledgeable about addiction.
- Many Wisconsin pharmacists needed greater knowledge about pain management and controlled substance requirements.
- State medical board guidelines had provisions that could restrict use of opioids for pain treatment; similar language was found in state pharmacy and nursing policies.