Pain specialists in the U.S. may need better training, both in government recommendations and in safety, if their responses to a recent survey are any indication.

Five months after the U.S. Food and Drug Administration announced its new risk management program for opioids, one third of pain clinicians say they are unclear on its details and 13% say they do not routinely assess patients for risk of misuse, the survey found.

"There is a definite need for education of prescribers based on a number of survey item responses," Bronwyn Boyes, who was involved in the study at MediCom Worldwide, Inc., a continuing medical education provider, told Reuters Health by email.

In light of the results, Boyes suggested that providers learn about current pain-management regulatory requirements, take continuing educational programs to minimize the risk associated with prescribing opioids, and routinely use and document the results of risk-screening tools in their practices.

Boyes and her colleagues presented their findings last week at a large pain conference in Las Vegas called Pain Week.

MediCenter sent its survey to 30,000 of its member clinicians and received responses from 634. Less than 70% of respondents correctly answered questions about opioid abuse and the FDA's new risk management strategies for extended-release or long-acting opioids.

Also, 72% said there is not enough information available about the strategies, and 43% incorrectly stated that the FDA now requires them to have special training before they can prescribe long-acting or extended-release opioids.

On a positive note, 81% said they were confident that they comply with federal and state prescription regulations.

The survey adds to a mounting clamor among health authorities for better training, both to offset a spike in opioid misuse in the U.S. and to lower healthcare costs.

The number of Americans age 12 and older who used opioids for non-medical purposes rose from 29 million in 2002 to 33 million in 2007, Dr. Janet Woodcock, director of FDA's Center for Drug Evaluation and Research said at a conference this past April.

Twelve thousand Americans died in 2007 from using prescription pain killers, according to Dr. Woodcock. "This problem is huge and it continues to grow every year. So it's clear that we need to take some action."

Her comments at the conference appear in a transcript on the FDA's website.

One of the key actions the FDA calls for is better training for clinicians.

Proper training could also ease some of the financial pressure that pain management puts on the healthcare system, the Institute of Medicine reported in June. Chronic pain afflicts 116 million Americans annually at a cost of $560 billion to $635 billion in healthcare and lost wage and productivity costs.

But many healthcare workers are not well prepared to provide a full range of pain care, the report said. Only five medical schools out of 133 in the country require pain courses, and only 17 offer pain elective courses.

The Institute of Medicine's report is available online for free from the National Academies Press.

"The survey results coupled with the recent IOM report highlights the need for further education of both clinicians and patients to address the current inadequacies in chronic pain management," Boyes said.

Rob Goodier • Reuters Health Information © 2011