Prescription Drug Abuse Rates Hound Providers

Twillman wants more physicians to be trained in pain management, a sentiment echoed by the American Society of Interventional Pain Physicians. Both ASIPP and AAPM are trumpeting training programs over a new proposal that changes labeling requirements on opioids.

PROP, Physicians for Responsible Opioid Prescribing, criticizes the labels for being too broad, and giving neither a time frame for use, nor a maximum dose for non-cancer pain. It wants opioid labels changed and has asked the FDA for three specific modifications:

• Strike the term "moderate" from the indication for non-cancer pain
• Add a maximum daily dose, equivalent to 100 milligrams of morphine for non-cancer pain
• Add a maximum duration of 90-days for continuous (daily) use for non-cancer pain

Andrew Kolodny, President of PROP, says its aim is not to stop doctors from prescribing painkillers when necessary. It wants to stop drug companies from promoting the drugs aggressively.

"The label changes will prohibit advertising but will not limit clinical decision making. If a doctor believes that a patient might benefit from long-term opioids, they will be permitted to prescribe. Off-label use of medications is very common and is often considered to be perfectly appropriate," Kolodny says.