AAN Warns Against Opioids in Chronic Noncancer Pain

By Kristina Fiore, Staff Writer, MedPage Today

The risks of opioids far outweigh their benefits in chronic pain conditions such as headache, fibromyalgia, and lower back pain, according to a new policy statement from the American Academy of Neurology.

The statement lists several best practices — including checking a prescription data monitoring program (PDMP) before prescribing opioids — and calls for primary care doctors to refer chronic pain patients to specialists if they are taking daily doses of 80 to 120 mg morphine-equivalent per day.

Gary Franklin, MD, of the University of Washington in Seattle, is the sole author of the statement, published in Neurology. Franklin is known for bringing to light a sharp increase in opioid overdose deaths in his tenure at Washington state’s workers’ compensation program — which many say sparked the nation’s awareness of a rising prescription opioid epidemic.

“The evidence of harm is high, and the effectiveness is low,” Franklin toldMedPage Today, calling attention to a graphic in the statement that shows the imbalance. “That is the whole story.”

AAN is the first national medical association to adopt a policy statement regarding opioids. Franklin’s home state has adopted dosing guidelines, which call for doctors to refer to pain management specialists when daily doses hit 120 mg morphine-equivalent — a policy that the CDC has also endorsed.



Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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