Diversion and Abuse of Controlled Substances

Miami Beach, FL - February 16, 2001 - This official position statement is issued at the annual meeting of the American Academy of Pain Medicine, the organization representing physicians who specialize in the practice of Pain Medicine.

We are very concerned and strongly opposed to the diversion and abuse of controlled substances and support law enforcement efforts to stop these criminal activities. However, there is an issue of greater importance to public health resulting from the inadequate treatment of patients with serious pain disorders.

To help prevent these problems, the American Academy of Pain Medicine worked with the U.s. Congress to declare this the Decade of Pain Control and Research, worked with the Federation of state Medical Boards to create a clinical guideline for the appropriate use of opioid medications in treating pain, and is developing an educational program for primary care professionals or pain assessment, opioid usage, and detection of addiction and prevention of diversion.

Millions of people have suffered unnecessarily because of barriers to effective pain treatment. Exaggerated and unrealistic fears of addiction are paramount among these barriers, which should not be reerected in response to publicity regarding drug abuse. Physicians should not be afraid to provide adequate analgesia when able to do so, and patients with acute pain and pain from cancer, AIDS, and other serious diseases should not fear the use of opioids, which are safe when used appropriately.

Experience and investigation have shown that when opioids are prescribed and used appropriately in the treatment of pain there is minimal danger of creating an addictive disorder. Evidence to date indicates that substance abuse problems have not increased as a result of the increased availability of therapeutic opioids. The public health problem represented by misuse of prescription opioids is miniscule in comparison with that of untreated and unrelenting pain.