US Military Updates Practice Guideline on the Management of Opioid Therapy for Chronic Pain

The U.S. Department of Veterans Affairs and the Department of Defense have released an update to their joint guideline on managing pain: Use of Opioids in the Management of Chronic Pain (2022). The guideline is formatted as three algorithms and 20 evidence-based recommendations related to (a) determination of appropriateness for opioids for chronic pain, (b) initiation of treatment with opioids, and (c) maintaining, tapering, discontinuing, or switching from full agonist opioids.

In addition to the full guideline, VA/DoD has also provided a Provider Summary and a Pocket Card for convenience.

Federal Funds Available Related to Pain Management and Telehealth Research

The federal government is currently a number of pain-related research initiatives:

CMS Seeks Feedback to Improve Equity and Access in Medicare Advantage

Separate from CMS’ Physician Fee Schedule proposal, the agency is also seeking feedback related to the Medicare Advantage program, hoping to hear from the public on topics including health equity, expanding access and coverage to affordable and sustainable care, driving innovation to promote person-centered care, and developing partnerships with stakeholders.

The official Request for Information is expected to be published on August 1, 2022, but an unpublished version is currently available for review. Public comments will then be accepted for a period of 30 days.

ICYMI: Supreme Court Refuses to Expand Criminal Liability in Opioid Prescribing Cases

In a 9-0 decision, the U.S. Supreme Court has unanimously held that physicians can only be convicted of violating the Controlled Substances Act when they intentionally or knowingly prescribe in an unauthorized manner. In the decision, Justice Breyer wrote that requiring a culpable mental state “helps to diminish the risk of ‘overdeterrence,’ i.e. punishing acceptable and beneficial conduct that lies close to, but on the permissible side of, the criminal line.”