Opioids and Cancer Pain Management in the United States: Public policy and legal challenges.

OBJECTIVE: To review current opioid guidelines, public policy, and legal challenges that can threaten optimal management of cancer pain.

DATA SOURCES: National guidelines, professional web sites, journal articles, essays.

CONCLUSION: Recent opioid legislation and increasing scrutiny from regulatory agencies have created multiple barriers for providers and patients to achieve pain control. These challenges include prescription limitations and practitioner fear of litigation, which can result in the under-prescribing or refusal to prescribe opioids.

IMPLICATIONS FOR NURSING PRACTICE: To provide excellent care, nurses must understand current policies affecting delivery of pain care to oncology patients and serve as patient advocates in the evolving policy debates.