Pain Management and Opioid Abuse

Challenges of Pain Management

Chronic pain management is a public health concern with significant increases in the use of opioids for pain relief. There is a corresponding growth in the number of opioids prescribed in the U.S. and the overdose from those drugs.1,2,3 Family physicians and other primary care providers play a vital role in balancing patients’ pain management needs with the risk of drug misuse and abuse.

The American Academy of Family Physicians (AAFP) is dedicated to finding solutions to the crisis of pain management and opioid abuse. We recognize that long-acting and extended-release opioids are powerful drugs that require oversight, but these drugs can be controlled without unduly limiting their proper use. Creating additional prescribing barriers for primary care physicians would limit patient access when there is a legitimate need for pain relief.

Treating Patients with Chronic Pain

Patients with chronic pain will often initially consult their family physician for treatment. Treatment may include subspecialists, but it is often the family physician’s role to coordinate and manage care, including the use of opioid pain relievers. The AAFP views the goal of pain management to be primarily improvement and maintenance of function. We urge family physicians to individualize treatment based on a review of a patient’s potential risks, benefits, side effects, and functional assessments, and to monitor ongoing therapy accordingly.

The AAFP, in conjunction with the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, and the Society of Teachers of Family Medicine, developed guidance to teach residents how to care for patients with chronic pain. Skills suggested include:

  • Understanding the pathophysiology of chronic pain
  • Evaluating a patient’s opioid abuse risk utilizing risk assessment tools
  • Establishing opioid contracts with patients
  • Interpreting urine toxicology screens
  • Performing chart reviews and adjusting treatment plans based on those reviews
  • Treating and monitoring patients at high risk of abuse
  • Prescribing narcotic alternatives
  • Performing selected joint injections

The AAFP will continue to be an active participant in issues concerning pain management and opioid abuse through advocacy, collaboration, and education. Use the resources on this page and on our healthy interventions page to guide your patients through pain management issues.

Healthy Interventions Pain Management & Opioid Abuse Resources

Gain access to valuable information and tools to help your practice and community address pain management and opioid abuse issues.


Read AAFP Policies & Papers

Policy

AAFP Substance Abuse and Addiction Policy

Papers

AAFP Position Paper

AAFP's position paper, Pain Management and Opioid Abuse: A Public Health Concern (15-page PDF), includes AAFP advocacy, clinical, continuing medical education, and collaboration recommendations.

AAFP Encourages Widespread Access to Naloxone: With the support of the AAFP, the American Medical Association Task Force to Reduce Opiod Abuse strongly encourages widespread access to Naloxone.  
Read the paper »(515 KB PDF)


Earn CME

FP Essentials™ edition on Chronic Pain Management(60 page PDF)

Free for AAFP members. Log-in required. Earn up to 5 AAFP Prescribed credits.
Take the quiz for CME credit »

CME Webcasts

Free for AAFP members. Log-in required. Earn up to 1 AAFP Prescribed credit for each webcast.

Chronic Opioid Therapy

Appropriate and Effective Pain Management - Overcoming the Barriers

Chronic Pain: Management and Safe Treatment

 


Access Journal Articles




Review Related Articles

AAFP's Dr. Wergin on Pain Management

Past AAFP president and current board chair, Robert Wergin, MD, FAAFP, was featured in a 2016 New York Times article about the complexities and challenges family physicians face when treating patients with chronic pain.