Interpreting Changes in State Laws and Regulations Governing the Use of Controlled Substances to Treat Pain
Pain is one of the most common physical complaints following an individual's admission into the healthcare system [1-6]. Moderate to severe pain is frequently reported to be experienced throughout hospitalization, during treatment, and following discharge. Unrelieved pain has been found to occur in numerous healthcare settings and to affect a variety of patient populations [7-16]. Individuals with chronic cancer or non-cancer conditions often experience pain that is debilitating and negatively impacts their quality of life [14,17-20].
There are many useful pharmacological and non-pharmacological treatments for pain, and opioid analgesics such as morphine can play an important role in relieving severe pain, especially when the pain results from cancer [20, 21]. Using opioids to treat non-cancer pain remains somewhat controversial [22]; however, practitioners should evaluate patients' pain during the initial evaluation and monitor their pain and functioning during treatment to determine whether opioids are, and remain, an effective therapeutic option [23]. Given these consideration, opioid therapy to improve pain relief and patient function remains a legitimate medical practice and has become a greater healthcare priority. As a result, there has been increased focus on the diverse factors that can interfere with the medical use of opioids for pain management and can negatively impact patients' access to effective pain relief. Most studies have focused on issues in the clinical domain, such as the knowledge and attitudes of healthcare professionals about the legitimate use of opioids [7, 18, 24-27], and patient and family perceptions about the use of opioids for pain relief [ 28-33]. However, restrictive federal and state policy can also inhibit the appropriate use of opioid medications, which can limit medical decision-making, create undue prescribing burdens, and impede patient care.