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:
- Development of Therapies and Technologies Directed at Enhanced Pain Management (R43/R44 – Clinical Trial Required). Aims to support the development of therapies and technologies directed at enhanced pain management through the Small Business Innovation Research program. In addition, NIH is interested in new screening tools and models focused specifically on pain and development of pain therapies including digital tools.
- Development of Therapies and Technologies Directed at Enhanced Pain Management (R43/R44 – Clinical Trial Not Allowed). Focused on applications for improving pain treatment, including the development of new non-addictive medications and devices and objective pain measurement. In addition, NIH is interested in new screening tools and models focused specifically on pain and development of pain therapies including the development of digital health technologies associated with pain and serious mental illness or suicide.
- Notice of Special Interest: High Priority Pain Research. The National Center for Complementary and Integrative Health is inviting applications to focus on pain-related research topic areas that include remotely delivered interventions.
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.”