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Do Opioid Prescribing Guidelines Use Pseudoscience?

Today’s Pharmacy Podcast Show guest is Dr. Jeffrey Fudin. We’re talking about the March 30th 2016 article from Pain News […]

April 15, 2016 Community Pharmacy, Compounding, Marketing Strategy, Patient Advocacy, Podcasts, Specialty Pharmacy

Today’s Pharmacy Podcast Show guest is Dr. Jeffrey Fudin. We’re talking about the March 30th 2016 article from Pain News Network:

How Opioid Prescribing Guidelines Use Pseudoscience

By Michael Schatman and Jeffrey Fudin, Guest Columnists

Recently, we (along with our colleague, Dr. Jacqueline Pratt Cleary) published an open access article in the Journal of Pain Research, entitled The MEDD Myth: The Impact of Pseudoscience on Pain Research and Prescribing Guideline Development.”

In this work, we address the issue of how governmental and managed care opioid guideline prescribing committees use the flawed concept of morphine-equivalent daily dose (MEDD or MME) to arbitrarily place limits on the amount of opioids that a clinician “should” prescribe to any patient with chronic pain — as if all patients were identical.

The article cites excellent research that exposes the invalid concept of MEDD – and while guideline authors are fully aware of that lack of evidence, they are hypocritically fine with using MEDD as a device to thwart chronic opioid use. In the case of opioids for chronic non-cancer pain, there is at least some evidence.  But for MEDD, there is no evidence.


Dr. Jeff Fudin graduated from Albany College of Pharmacy & Health Sciences with a bachelor’s degree and PharmD. He is a Diplomate to the American Academy of Pain Management, a Fellow to ACCP, a Fellow to ASHP, and a member of several other professional organizations. He is founder and CEO of Remitigate, LLC (, a software platform for interpreting urine drug screens (Urintel) and pharmacogenetics(Phenotel).
Dr. Fudin is a section editor for Pain Medicine and serves on the editorial board for Practical Pain Management. He is founder/chairman of Professionals for Rational Opioid Monitoring & Pharmacotherapy (PROMPT), an advocacy group in favor of safe opioid prescribing. He practices as a clinical pharmacy specialist and director of PGY-2 pharmacy pain residency programs at the Stratton Veterans Administration Medical Center in Albany, New York. He is an adjunct associate professor of pharmacy practice at Western New England University College of Pharmacy and an adjunct assistant professor of pharmacy practice at the University of Connecticut School of Pharmacy.
Dr. Fudin can also be found at his professional website,

Contact Info:

Dr. Jeffrey Fudin 


Twitter: @JeffreyFudin


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