Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines
Background: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015.
The purpose of the Appropriate Use of Drug Testing in Clinical Addiction Medicine is to provide guidance about the effective use of drug testing in the identification, diagnosis, treatment, and promotion of recovery for patients with, or at risk for, addiction.
Inspection findings were supplemented by fieldwork in eight prisons in 2014 to generate an overall picture of drug use and responses to it in prisons in England and Wales. In the face of rapidly changing and varied drug use patterns, policy and operational responses were seen as insufficiently flexible and dynamic, though treatment had “dramatically” improved.
This five year survey is a global model for its rigor – the only national prevalence survey that I know of in the world where questionnaires were combined with 100% toxicology testing of three biological samples per person (hair, urine, saliva) and 10 panels of drugs, resulting in over 30,000 toxicological tests covering 75% of the country’s urban centers and 52 villages in most provinces.
The survey also includes: