American Pain Society Slams McCaskill Report on Opioids

Megan Brooks

February 15, 2018

The American Pain Society (APS) is "disappointed" with Senator Claire McCaskill's (D-MO) report on financial support for pain organizations from opioid manufacturers, charging that the report contains "simplistic, misleading and insulting conclusions regarding support that APS has received in recent years from the pharmaceutical industry."

"We are also disturbed that no one from the Senator's staff contacted APS to inquire and learn the truth about our policies and procedures governing industry grants. Had they done so, we would have explained in detail the educational and pain research initiatives APS continues to pursue to help resolve the opioid crisis," the APS said in a statement.

The McCaskill report, released February 12, found that five opioid manufacturers made contributions of nearly $9 million to 14 third-party pain advocacy groups between 2012 and 2017.  The APS, the Academy of Integrative Pain Management, and the American Academy of Pain Medicine are among the groups mentioned in the report.

The report said initiatives from these groups often "echoed and amplified messages favorable to increased opioid use — and ultimately, the financial interests of opioid manufacturers." 

It also charges these groups of issuing guidelines and policies "minimizing the risk of opioid addiction and promoting opioids for chronic pain, lobbied to change laws directed at curbing opioid use, and argued against accountability for physicians and industry executives responsible for overprescription and misbranding."

"The pharmaceutical industry spent a generation downplaying the risks of opioid addiction and trying to expand their customer base for these incredibly dangerous medications and this report makes clear they made investments in third-party organizations that could further those goals," McCaskill said in a statement. 

"These financial relationships were insidious, lacked transparency, and are one of many factors that have resulted in arguably the most deadly drug epidemic in American history," she added.

The report also noted a lack of transparency, given that the advocacy groups are not obligated to disclose their donors publicly, an issue McCaskill said needs addressing.

"The financial relationships between these groups and opioid manufacturers should be clear to the general public," she said.

"Simplistic and Incorrect"

The APS counters in their statement that "in any given year, APS revenues from industry are devoted to unrestricted grants for education and specific projects, such as young investigator research (whereby the grantors are not allowed to influence content), advertising, and exhibits.

"It appears Sen. McCaskill unfairly and naively equates financial support with undue industry influence and control.  This simplistic and incorrect assumption damages our reputation for scientific integrity and advocacy on behalf of pain management clinicians, researchers and patients. We wish the Senator's office had taken the time to speak with APS leadership before writing its report," the APS said.

The APS points to their significant role in combating the opioid epidemic. "APS leaders were major contributors to the landmark National Pain Strategy (NPS). The Society is active in developing policy recommendations to implement the NPS goals to expand opioid education and training for prescribers and to increase funding for pain research to improve treatment options that mitigate the use and need for opioids in the clinical setting," the APS said.

The American Academy of Pain Medicine has also responded to the McCaskill report, noting that the Academy's policies "prohibit our education and advocacy positions to be compromised by outside influences, such as pharmaceutical companies, just as newspapers and other media outlets don't allow advertising to compromise their editorial integrity."

"As pain physicians, our primary commitment is to provide the best possible care and treatment to our patients," the Academy said in a statement.

The Academy said it supports the 2016 Centers for Disease Control and Prevention (CDC) opioid prescribing guidelines, which were "created to promote safer use of opioids — not to prohibit their use — and believes that opioids should be considered as part of a comprehensive pain management plan. Anything less could put the health of our patients at risk."

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