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American Academy of Pain Medicine Rejects “Fake News”

The American Academy of Pain Medicine stands by our colleagues in the AMA to condemn the statements by President Trump referenced in a recent New York Times article, regarding accusations of profit and self-interest in taking care of patients during the pandemic. Physicians have put themselves and their families at risk in executing their Hippocratic oath to treat patients despite the personal risks. In addition to balancing the treatment of acute and chronic pain with the need to keep our patients safe from COVID, a majority of our members are anesthesiologists, many of whom are working in hospitals to take care of the critically ill as well. At AAPM we support our members’ selfless dedication to our patients, despite the risks of personal harm.

AAPM Signs AMA Letter Discouraging CMS Expansion of NPP Services in IRF Settings

The American Medical Association (AMA), AAPM, and other leading health care organizations released a letter on June 11, 2020, responding to a proposal by the Centers for Medicare and Medicaid Services (CMS) that would allow non-physician providers (NPPs) to provide services at Inpatient Rehabilitation Facilities (IRFs) that are currently limited to rehabilitation physicians. The letter discourages the expansion by emphasizing its potential to “undermine delivery of and access to physician-led team-based care” in IRFs. Full letter.

AAPM Statement on Racism in Health Care

The American Academy of Pain Medicine condemns racism and acknowledges its heavy toll on public health. Racial and ethnic disparities in pain treatment and pain treatment outcomes have been widely documented. AAPM is committed to working with its members and the health care community at large to eradicate these disparities, so that all health care professionals and persons seeking health care and pain care are safe, respected, and valued. 

American Pain Society

The American Academy of Pain Medicine (AAPM) is disheartened to learn of the dissolution of the American Pain Society (APS). Over the past nearly 40 years, AAPM has been fortunate to serve alongside APS in shared efforts to advance pain education, research, and advocacy. The closing of this long-standing organization is a loss for the entire pain community. AAPM offers its support to APS leaders, staff, and members, whom we remain committed to working with to advance multidisciplinary and patient-centered pain care.

AAPM Issues Updated Position Statement on Research into the Use of Cannabinoids for Medical Purposes

More than 30 states as well as Washington D.C. have legalized cannabis for medical purposes, making it more accessible than ever before to patients throughout the country, including patients suffering from chronic pain. However, major systematic reviews on the use of cannabinoids for chronic pain have yielded conflicting conclusions regarding their effectiveness and safety.

“The lack of high quality, evidence-based clinical research into the use of cannabinoids for chronic pain, leaves both clinicians and patients at a distinct disadvantage when weighing the risks and benefits of considering cannabinoids as a pain treatment,” says AAPM Scientific Review and Guidelines Committee Co-Chair, Michael D. Osborne, MD.

On May 30 the AAPM Board of Directors approved an updated position statement on research into the use of cannabinoids for medical purposes, urging FDA to reschedule cannabinoids from Schedule I to Schedule II in order to facilitate needed research into the medical effectiveness, substance toxicity, and overall safety of these products for the treatment of pain. Read the full position statement.

“AAPM promotes individualized, patient-centered pain care delivered by a multidisciplinary team and employing the wide variety of therapies available to improve patient function and reduce suffering. In order for cannabinoids to become a trusted part of the pain management tool kit, it is essential to conduct further research,” says AAPM Scientific Review and Guidelines Committee Co-Chair, Randall Brewer, MD. “We believe that rescheduling tetrahydrocannabinol, an active ingredient in marijuana, will be a critical step in facilitating the necessary research to determine the role of cannabinoids in the treatment of chronic pain.”

AAPM Commitment Statement on Countering the U.S. Opioid Epidemic

The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the increasing toll of the harms that can arise from opioid use disorder. As a step toward addressing these challenges and reversing the opioid epidemic, AAPM is a committed partner organization to the National Academy of Medicine’s (NAM) Action Collaborative on Countering the U.S. Opioid Epidemic. In addition to serving as a NAM Action Collaborative Network Member, the Academy is represented by Immediate AAPM Past President Jianguo Cheng, MD PhD on two of the Action Collaborative’s working groups: the Health Professional Education and Training Working Group and the Research, Data, and Metrics Needs Working Group.

As a multidisciplinary professional society, AAPM is committed to improving the care of patients with acute, chronic, and end-of-life pain. Chronic pain alone affects more Americans than diabetes, heart disease, and cancer combined; costs our nation hundreds of billions dollars in lost productivity; and creates tremendous suffering for patients and their families. While AAPM members, the organizations and individuals that contribute to the NAM Action Collaborative on Countering the U.S. Opioid Epidemic, and our entire nation work to address the ongoing opioid epidemic, it is important to remember that opioids are only one of many tools available to treat pain. AAPM members utilize the full spectrum of treatment options, including physical/cognitive/behavioral, pharmacological, interventional, surgical, and integrative modalities. AAPM is especially interested in solutions to the opioid crisis that value research, education, training, and advocacy for improved patient access to pain care that is comprehensive and patient-centered, and that employs a multidisciplinary, team-based approach to multimodal and individualized patient care.

AAPM is committed to lending its collective medical expertise and working with other organizations, including federal agencies such as NAM, to find real solutions to our nation’s opioid epidemic. We believe that federal and state policies should be directed at reducing the problem of opioid over prescribing while, at the same time, allowing appropriate access to all treatment modalities for patient with acute, chronic, and end-of-life pain and for patients with substance use disorder.

Response to Inquiries about Payments from Opioid Manufacturers

A statement from the American Academy of Pain Medicine

As a professional medical society, the American Academy of Pain Medicine (AAPM) is committed to integrity and transparency in all of its activities. Like other professional medical societies, the Academy relies on a number of revenue sources, including membership dues, event registration fees, unrestricted educational grants, industry sponsored activities, and the sale of trade show exhibit space and advertising.

Industry sponsorships, trade show exhibits, and advertising sales represent business transactions with external companies that seek to reach the Academy’s constituents. While the Academy does not impose strict editorial control, it does have policy that helps ensure appropriate standards of accuracy are maintained.

When accepting unrestricted educational grants, the Academy adheres to the standards established by the Accreditation Council for Continuing Medical Education (ACCME), which accredits nearly 2,000 organizations across the country. The ACCME Standards for Commercial Support require that professional medical societies exclude industry from any influence, direct or indirect, over speakers and educational content.

In its most recent accreditation cycles (2012-17 and 2018-23), the Academy was awarded Accreditation with Commendation as a provider of continuing medical education for physicians. The six-year accreditation is the highest level awarded by the ACCME.

Surgeon General Public Health Advisory Urges More Americans to Carry the Opioid-Reversing Drug, Naloxone

A statement from the American Academy of Pain Medicine

The American Academy of Pain Medicine (AAPM) applauds U.S. Surgeon General Jerome M. Adams, MD, MPH comments urging more Americans to carry naloxone, a lifesaving medication that can reverse the effects of an opioid overdose.

In a public health advisory, the Surgeon General encouraged patients currently taking high doses of prescribed opioids as well as other members of the medical community and general public to carry naloxone as a preventative measure.

As the Academy outlined in its July 2015 comments supporting efforts to maximize the availability of naloxone, naloxone saves lives and has no significant negative effects.

“AAPM strongly supports easy and widespread access to naloxone as an important tool for reversing potentially fatal opioid overdoses as part of the comprehensive response to the opioid epidemic,” says AAPM President Steven P. Stanos, DO. “The Academy looks forward to working with the Surgeon General’s Office to further raise awareness, education, and support related to the use of naloxone.”

AAPM Supports FDA in Development of Evidence-Based Opioid Prescribing Guidelines

A statement from the American Academy of Pain Medicine

The American Academy of Pain Medicine (AAPM) welcomes FDA Commissioner Scott Gottlieb’s comments suggesting the development of evidence-based opioid prescribing guidelines. We stand at the ready to participate in the development of these guidelines for common procedures that could then be incorporated into drug labeling, including the need to safely control patients’ post-operative pain, with time-limited opioid medications when necessary, while at the same time limiting any over-prescribing of opioid medications.

As pain physicians, our primary commitment is to provide the best possible care and treatment to our patients. AAPM represents a diverse scope of physicians who are on the front lines of helping patients manage their pain, through a multidisciplinary approach, incorporating a variety of modalities. Our members include anesthesiologists, internists, neurologists, physiatrists, psychiatrists, surgeons and others.

AAPM members are the most knowledgeable and experienced physicians to assist the FDA in developing evidence-based opioid prescribing guidelines, and we look forward to the opportunity to share our expertise with the FDA.

AAPM Statement on National Decline in Opioid Prescribing

A statement from the American Academy of Pain Medicine

Data released by IQVIA, a health care consulting company that regularly gathers prescribing data from pharmacies across the country, documenting a 22-percent decrease in opioid prescriptions nationally between 2013 and 2017 clearly shows that prescribers have been more judicious in prescribing opioids to their patients. It also reinforces a key tenant of pain medicine: there are alternative medication and non-medication modalities for treating pain, and opioids are only one of many treatment options that healthcare providers can utilize to help treat their patients and improve their quality of life.

When juxtaposed with the staggering increase in opioid-related overdoses and deaths in the same period, a 22 percent decrease in opioid prescribing is striking for other reasons as well. Together, these statistics shine a bright light on the fact that many Americans are increasingly likely to obtain illicitly manufactured fentanyl, heroin, and even more deadly contaminated heroin and fentanyl, leading to overdoses and tragic deaths and less likely as part of a clinician-prescribed treatment plan for patients with chronic pain. Clearly, simply writing fewer opioid prescriptions may help to decrease availability for misuse and abuse of prescription opioids and other adverse events, but will not be the single answer to our growing national opioid epidemic.

Further, these IQVIA statistics underscore the importance of differentiating addiction from chronic pain disorders. In contrast to the sharp decline of opioid prescriptions, opioid related deaths are on the continual rise. People with pain and people suffering with addictive disorders need access to respective pharmacologic, behavioral, and other treatment modalities. As members of AAPM, we remain dedicated to helping to improve the function and quality of life for people in pain and facilitating the identification and referral of patients with addiction to professional providers.

Pain Medicine Journal
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American Academy of Pain Medicine