Family Physicians on Front Lines of Chronic Pain Treatment

LEAWOOD, Kan. — Family physicians are the health professionals that many patients turn to for help with multiple health conditions, and pain management is often a necessary part of treatment. Limitations of prescribing rights would harm patients by making it difficult for many and impossible for some to get legitimate prescriptions to treat chronic and severe pain.

Any prescription drug has the potential to be abused. It is unfortunate that a few physicians are enabling that abuse. They should be punished as appropriate under the law. However, restricting prescribing rights as some suggest does not address the abuse problem — it punishes legitimate use. Limiting the ability of family physicians, who are trained to recognize and treat pain, to prescribe pain medication would force millions of patients with legitimate conditions to go untreated, or force them to seek treatment from a pain specialist, the closest of whom may be hundreds of miles away.

More than 210 million office visits are made to family physicians each year — 76 million more visits than to any other medical specialists. Family physicians are on the front lines of American health care, treating patients with chronic pain complaints such as headache, lower back pain, cancer pain, arthritis pain and pain resulting from traumatic injury, as well as end-of-life pain. Trained family physicians and other specialists must be trusted to provide their patients with the appropriate assessment and treatment of pain.

Recognizing the increasing need for chronic pain management education as America’ s population ages, the AAFP continues to offer continuing medical education programs on pain management. Among the tools provided to family physicians are several simulated patient cases that can be found online at http://www.aafp.org/cases.xml. In these cases, the simulated patients are “treated” using the same interactive decision-making process that physicians follow in real clinical situations, making differential diagnoses, ordering tests and interpreting the results, and then selecting a treatment plan corresponding to the final diagnosis.

The solution to the problem of illegal drug use is not to impose limits on physicians who are trained to treat chronic pain and prescribe medications. Diversion and abuse of opiates and other prescription medications is an issue for law enforcement officials to address in conjunction with the communities they serve.