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Concerns About Walmart’s New Policy on Opioid Prescriptions

A statement from the American Academy of Pain Medicine 

The American Academy of Pain Medicine (AAPM) echoes concerns raised by the American Medical Association (AMA) in response to Walmart's corporate policy that restricts initial opioid prescriptions for acute pain to no more than a seven-day supply and 50 morphine milligram equivalents (MME) per day. 

As mentioned in an October 3 letter the AMA directed to Paul Beahm of Walmart, Inc., this new policy is not aligned with the Centers for Disease Control and Prevention (CDC)'s Guideline for Prescribing Opioids for Chronic Pain. The CDC itself has emphasized that "clinical decision making should be based on a relationship between the clinician and the patient, and an understanding of the patient's clinical situation, functioning and life context." AAPM supports efforts to limit inappropriate prescribing but believes that legislation and regulatory policies should not discourage or prevent prescribing opioids where medically indicated and appropriately managed. While Walmart's intention with this corporate policy is to help prevent opioid abuse, forcefully placing limits on the prescription of pain medications could harm patients. 

In order to give patients who are suffering from postoperative or post-traumatic pain the best treatment option, there cannot be a hard threshold on the duration or amount of opioid prescription. Such a restriction is detrimental to patient care, not evidence-based, and ethically flawed. Comprehensive and patient-centered pain care should be diagnosed, assessed, and treated by licensed healthcare providers without interruption by corporate policies that are ill-informed and arbitrary. 

It is a dangerous and slippery slope for a corporate entity such as Walmart to override the treatment recommendations of a licensed physician and decide dosing for any patient who is in pain.

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