Curbing Opioid Abuse While Aiding Patients.

• Position: Brief Article

In response to news reports of widespread diversion and abuse of a frequently used cancer pain medication, the American Pain Society has urged policymakers to strike a balance in curbing abuse without creating barriers to the appropriate use of potent analgesic drugs. "We are concerned that the increasing problem of diversion and abuse of opioid medications could be decreasing access to them for valid medical purposes," says Michael Ashburn, the Society's president. "For example, there have been reports that pharmacies are refusing to stock certain drugs for fear of theft and that some physicians are now reluctant to prescribe them."

Opioid medications, like morphine, have diversion problems, but are legitimately used for treating severe cancer pain, especially in terminal patients. One such drug, OxyContin, has become popular among abusers for its ability to produce a rapid euphoric high when tablets are crushed and sniffed or injected.

Several years ago, the American Pain Society and the American Academy of Pain Medicine developed consensus guidelines covering the use of opioids for treatment of chronic pain that clearly spell out a process to be followed when using them in a clinical setting. "Opioids alone are rarely effective in the treatment of chronic pain," Ashburn maintains. "They can work well in some patients as part of an interdisciplinary approach to pain management. However, they must be used responsibly and appropriately."

He notes...