Evidence
What is established, and what is not
A program that asks a public agency to spend public money should be able to say where its evidence is strong, where it is mixed and where it is genuinely absent. This section does that.
The convention on these pages: each one states what the research question was, who was actually studied, what was found, and what the study design could not capture. Where a finding cuts against a component of this program, it is reported anyway.
Pages in this section
- The Pain Management Best Practices Inter-Agency Task Force — the federal consensus this program is built on.
- The 2016 and 2022 prescribing guidelines — what each says, and what happened when the first was applied as a rule.
- Tapering and discontinuation — the strongest and most uncomfortable evidence in this whole area.
- Urine drug testing — where a federally funded systematic review found a lack of evidence.
- Prescription drug monitoring programs — what they demonstrably do and what they do not.
- Pharmacogenomics of opioid response — real variability, and the gap between explaining variability and predicting a dose.
- What is not established — the honest list.
Why we publish the weak parts
Two reasons. The first is that a program built on overstated evidence fails in a way that damages the agency that bought it. The second is that the patients this work concerns have already been on the receiving end of confident claims that turned out to be wrong — in both directions. Restraint is not a marketing posture here; it is the substance of the argument.
The full reference list for the site is at /references/.