Pain Management in an Opioid Epidemic: What’s Appropriate, What’s Safe

Additional resources for providers

Many other resources are available for prescribers of controlled substances. For example, the CDC has published guidelines for prescribing opioids to patients with chronic pain, with a goal of increasing patient–provider communication.¹⁶ Additional goals include improving the safety of opioid use, maintaining the effectiveness of treatment, and reducing the necessity and practice of long-term therapy.

The FDA has also published a blueprint on how opioid analgesics can be formulated to deter abuse and, thus, be safer.³⁰ Although directed at the pharmaceutical industry—the FDA encourages manufacturers to develop abuse-deterrent mechanisms, such as physical and chemical barriers, aversion technology, and new delivery systems—the guidance may enlighten providers on how abusers can alter or manipulate oral opioids to achieve the desired effects.³⁰

CONCLUSION

Because NPs and PAs are authorized to prescribe Schedule II-V drugs in their scope of practice, they must have knowledge of drug-seeking behaviors and drug misuse before they prescribe opioids for pain relief. They must be attentive to patients’ pain-control needs and consider how to avoid or reduce the potential for misuse and abuse. Understanding the experience of pain and how opioids modulate it, as well as using available risk-assessment strategies, will help providers offer safe, effective treatment to their patients.