Comments Submitted Regarding Agency for Healthcare Research and Quality Draft Reports

Nov 19, 2019

ASRA submitted comments to the Agency for Healthcare Research and Quality (AHRQ) on November 12 regarding its draft reports on 1) Nonopioid Pharmacologic Treatments for Chronic Pain and 2) Opioid Treatments for Chronic Pain.

ASRA expressed concern that the first report does not fully address the risks and benefits for each nonopioid medication included in the analysis and that it does not appropriately balance the use of nonopioid drug regimens against patients’ comorbid conditions. ASRA noted that "nonopioid drug therapies are not necessarily a replacement for the use of opioids in managing chronic pain" and that "clinical experience suggests that long-term opioid therapy may be helpful in some patient populations."

In developing a long-term treatment strategy, clinicians must balance the risks of any drugs along with individuals' comorbidities and other potential treatment options. Nonopioids and alternative treatments should be considered first, but if they are not effective, opioids should be tested on a trial basis in a well-controlled environment, according to the comments.

"... the type, dosage, and duration of any pain treatment, including opioid therapy, is best determined by the treating clinician in accordance with each individual patient’s need," the authors wrote, concluding that  AHRQ should consider additional studies and work with the pain management community "to establish a more comprehensive evidence base around these topics."

Read the full comments here.

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