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The Potential for Unintended Consequences from Public Policy Shifts in the Treatment of Pain

Published online by Cambridge University Press:  01 January 2021

J. David Haddox  and
Gerald M. Aronoff
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Extract

Recently, due to a number of converging factors, there have been significant shifts in public policy regarding the legitimacy of treating chronic pain with opioids. Traditional tenets handed down in medical, dental, nursing, and pharmacy education created a distinct reluctance on the part of practitioners to prescribe opioids on a continual basis. Much has been written about the reasons for these attitudes. One of the barriers that is very consistently reported by prescribers is the fear of regulatory and legal repercussions to ongoing prescription of this class of medications. It is in this arena that sentinel changes have occurred, the most recent of which is the promulgation of a document prepared by the Federation of State Medical Boards (FSMB), which suggests a set of guidelines meant to be endorsed or adopted by individual medical licensing boards on how to approach this particular aspect of practice. These guidelines, representing a broad consensus from a wide constituency, were developed in a relatively open forum and detail a balanced approach to the prescription of opioids for chronic pain.

Type
Commentary
Information
Journal of Law, Medicine & Ethics , Volume 26 , Issue 4 , Winter 1998 , pp. 350 - 352
Copyright
Copyright © American Society of Law, Medicine and Ethics 1998

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References

See, for example, Portenoy, R.K., “Opioid Therapy for Chronic Nonmalignant Pain: Clinicians’ Perspective,’ Journal of Law, Medicine & Ethics, 24 (1996): 296–309; McQuillan, R.J., “Narratives on Pain and Suffering: Mary's Story,” Journal of Law, Medicine & Ethics, 24 (1996): 288–89; and Cassel, C.K., “Narratives on Pain and Comfort: Dr. M's Story,” Journal of Law, Medicine & Ethics, 24 (1996): 290–91.CrossRefGoogle Scholar
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See Federation of State Medical Boards of the United States, Inc., Model Guidelines for the Use of Controlled Substances for the Treatment of Pain (Euless: Federation of State Medical Boards, May 1998).Google Scholar
See, for example, Texas’s Intractable Pain Treatment Act of 1989, Tex. Rev. Civ. Stat. Ann. art. 4495c (West 1996).Google Scholar
See California’s Pain Patient’s Bill of Right, Cal. Health & Safety Code §§ 124960–124961 (West 1998).Google Scholar
See, for example, Tex. Rev. Civ. Stat. Ann. art. 4495c, § 2(3).Google Scholar
See, for example, California’s Intractable Pain Treatment Act, Cal. Bus. & Prof. Code § 2241.5 (West 1998).Google Scholar
See, for example, Tex. Rev. Civ. Stat. Ann. art. 4495c, § 6(a)-(b).Google Scholar