A 3-step analgesic ladder was introduced in 1986 and needs change. Surgical interventions could reduce opioid use and motivate expansion of current pain management approaches.
AMA J Ethics. 2020;22(8):E695-701. doi:
10.1001/amajethics.2020.695.
Differentiating between best palliative care options and the curative and palliative potential of surgery is key to developing dual intentional clarity.
AMA J Ethics. 2021;23(10):E766-771. doi:
10.1001/amajethics.2021.766.
Dr Travis Rieder discusses his own experiences with opioids and the ethical challenges of “legacy patients,” and Dr Stephanie Zaza, president of the American College of Preventive Medicine, discusses the future of opioid research priorities.
There are numerous state and federal laws designed to protect against misuse and diversion of prescription drugs that apply to patients' behavior, physicians' prescribing practices, and dispensing.
Though there are channels through which terminally ill patients can access some experimental drugs that have not yet received FDA approval for marketing to the public, in general those drugs must already be proven safe and effective.
Conflicts between federal and state laws governing marijuana, lack of evidence about its efficacy as a treatment, and physicians' inability to predict or control dosage would all be aided by reclassification of the drug that would let clinical research go forward.