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.