Earlier this month I was honored to be an invited speaker at a Washington D.C. Congressional Briefing focused on the “Opioid Recovery Act of 2018.” The open session drew key stakeholders from varied backgrounds. I used my time to describe how my PCORI-funded research project is an important part of the solution.
Latest data suggests that almost 18 million Americans are taking long-term prescription opioids. Currently, there is no good evidence for how to best reduce long-term prescription opioids in community outpatients who wish to do so. Published in JAMA Internal Medicine, our pilot research suggested that our voluntary patient-centered opioid tapering program is gentle and effective for patients who wish to reduce their daily opioid doses. Now, with the PCORI-funded EMPOWER study, we are taking our patient-centered method and embedding it into multiple clinics in the U.S. We are testing the added benefit of two types of empowering pain management classes to help patients best manage pain while they reduce their prescription opioids in a patient-centered way. The end product will be the evidence and methods to help doctors, patients, and their families know how to help patients safely, effectively, and comfortably reduce opioids and live better with chronic pain.
A one-size-fits-all approach to managing pain and reducing opioids is doomed to fail. Earlier this year, I described in my Nature article that patient-centeredness is the way forward for best pain care. We must attend to the needs of each individual in order to best care for patients who are living with complex medical conditions. More than ever, a clinical and ethical imperative requires that we invest in treating pain better. This means offering patients a comprehensive, multidisciplinary treatment approach that allows patients access to a broad range of evidence-based pain treatments. And, in an era of extreme opioid reduction and legislation, we must recognize that opioids do help some patients who are living with complex medical conditions. We must protect and preserve their access to the pain treatment that helps them live better.
In the past two months I have been advocating at the state, national, and international levels for protections for patients with chronic pain taking legacy long-term opioid prescriptions. Policies are getting ahead of the evidence, and this is deeply concerning because we risk inflicting further suffering on the most vulnerable patients. Methods matter in reducing prescription opioids. We must have careful patient selection processes, protections, and monitoring systems in place to assure patient safety, comfort, and best outcomes. In my patient-centered work, I focus on helping patients who wish to reduce their opioids do so successfully—this is the philosophy of the EMPOWER study. When we focus on helping patients meet their goals in a patient-centered way, everyone wins.