The American Academy of Neurology has released a position statement in its journal Neurology, in which the professional group says that the risks associated with opioid medications are too high to justify using the drugs for chronic conditions like headaches and back pain. MedPage Today reports that the AAN is the first professional organization to adopt an opioid policy, which includes best practices such as advising members to check local prescription data monitoring programs and referring patients to pain specialists if they are taking 80mg to 120mg of a morphine equivalent a day.

The American Academy of Pain Management responded to AAN’s position, telling MedPage Today that the recommendations are sound, but fail to address “the toll exacted by inadequately treated chronic pain.”
The AAPM also objects to the neurology association’s recommendation that confirmed opioid abusers be shunned from the practice, and recommends assessing the reasons for misuse or misbehavior—which can include securing medications from multiple doctors and/or handing out drugs to third parties—and handling the issue in a contextually appropriate manner.

The debate between associations is happening a week before hydrocodone-containing products move from the relatively easy-to-access Schedule III category to the DEA’s more restrictive Schedule II tier. The impact of this switch includes allowing only ER doctors to call in prescriptions, while requiring all others to use paper ones for medications like Vicodin.