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Suggested Citation:"Appendix A: Statement of Task." National Academies of Sciences, Engineering, and Medicine. 2019. Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25435.
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Appendix A

Statement of Task

An ad hoc committee will plan and host a 1-day workshop to examine ways to best address the pain management needs of people with serious illness in the context of widespread opioid use disorder, including consideration of the underlying socioeconomic factors that contribute to the epidemic. The workshop will feature invited presentations and panel discussions on topics that may include

  • The Patient/Family Perspective
    • Impact of limitations in access to opioids on those with serious illness and their caregivers
    • Disparities in access to prescribed opioids for people with serious illness
    • Options for safe removal and disposal of opioids when they are no longer needed
  • The Clinician Perspective
    • How restrictions on opioid prescribing affect clinicians and their ability to provide high-quality care for those with serious illness
    • Ways in which clinicians manage the care of seriously ill patients who have comorbid conditions such as cancer and substance use disorder
Suggested Citation:"Appendix A: Statement of Task." National Academies of Sciences, Engineering, and Medicine. 2019. Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25435.
×
  • The Payer Perspective
    • Challenges of striking a balance between access to opioid medications for patients’ pain management and patient safety and prevention of opioid use disorder
  • The Legislative/Policy Perspective
    • Potential impact of regulatory/legislative actions to address the opioid epidemic
    • Measures to protect the population of people with serious illness whose pain can only be effectively addressed by opioids
  • Strategies to address gaps in the evidence base on pain management for people with serious illness

The committee will develop the agenda for the workshop, select speakers and discussants, and moderate the discussions. Proceedings of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.

Suggested Citation:"Appendix A: Statement of Task." National Academies of Sciences, Engineering, and Medicine. 2019. Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25435.
×
Page 77
Suggested Citation:"Appendix A: Statement of Task." National Academies of Sciences, Engineering, and Medicine. 2019. Pain Management for People with Serious Illness in the Context of the Opioid Use Disorder Epidemic: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25435.
×
Page 78
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The United States is facing an opioid use disorder epidemic with opioid overdoses killing 47,000 people in the U.S. in 2017. The past three decades have witnessed a significant increase in the prescribing of opioids for pain, based on the belief that patients were being undertreated for their pain, coupled with a widespread misunderstanding of the addictive properties of opioids. This increase in prescribing of opioids also saw a parallel increase in addiction and overdose. In an effort to address this ongoing epidemic of opioid misuse, policy and regulatory changes have been enacted that have served to limit the availability of prescription opioids for pain management.

Overlooked amid the intense focus on efforts to end the opioid use disorder epidemic is the perspective of clinicians who are experiencing a significant amount of daily tension as opioid regulations and restrictions have limited their ability to treat the pain of their patients facing serious illness. Increased public and clinician scrutiny of opioid use has resulted in patients with serious illness facing stigma and other challenges when filling prescriptions for their pain medications or obtaining the prescription in the first place. Thus clinicians, patients, and their families are caught between the responses to the opioid use disorder epidemic and the need to manage pain related to serious illness.

The National Academies of Sciences, Engineering, and Medicine sponsored a workshop on November 29, 2018, to examine these unintended consequences of the responses to the opioid use disorder epidemic for patients, families, communities, and clinicians, and to consider potential policy opportunities to address them. This publication summarizes the presentations and discussions from the workshop.

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