According to the CDC:
“This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The guideline addresses 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use.”
In the guidelines, three principles of the 12 recommendations were considered essential for patient care:
- For chronic pain outside of active cancer, palliative, and end-of-life care, nonopioid therapy is preferred.
- To reduce risks of opioid use disorder and overdose, the lowest possible effective dosage should be prescribed when opioids are used.
- Providers should always exercise caution when prescribing opioids and monitor all patients closely.
However, with opioids being a highly-discussed topic in the news—”How the Epidemic of Drug Overdose Deaths Ripples Across America,” “Massachusetts Governor Chokes up at Painkiller Bill Signing,” “The Opioid Epidemic Across the Supply Chain,” “Drug Overdose Deaths Hit ‘Alarming’ New Record in U.S., CDC Says,” etc.—many parties have come forward to voice their opinions and resulting actions.
There are also many parties who feel strongly that the CDC’s recommendations have fallen short.
“The Alliance for Balanced Pain Management agrees that primary care doctors prescribing opioids should proceed cautiously and discuss all possible risks with patients. But when the CDC suggests the exact number of days and the precise dosing limit, the agency may be inserting itself too far, interfering with physician care of patients who live day to day with serious pain,” said Brian Kennedy, Alliance for Balanced Pain Management (AfBPM) Steering Committee Member. “These guidelines mark a milestone in the national conversation about how we treat pain, both chronic and acute.”
Cindy Steinberg, National Director of Policy and Advocacy for the U.S. Pain Foundation, a patient advocacy group which receives funding from opioid manufacturers, said she’s worried the guidelines may negatively impact patients suffering with severe pain. “I am concerned that if these guidelines go forward as they are now written, they will lead to further restrictions on access to opioids for people with unremitting pain who truly need them and take them responsibly,” she said.
“It’s a game-changer,” said Andrew Kolodny, the Director of Physicians for Responsible Opioid Prescribing and the Chief Medical Officer of Phoenix House, a nonprofit drug rehabilitation organization. “It’s the first time that the federal government is clearly communicating to the medical community that opioids are not appropriate for long term use, that the risks outweigh the benefits.”
According to once source:
“Some groups voiced considerable opposition to the [opioid] guidelines at a meeting last December of the Interagency Pain Research Coordinating Committee. However, the meeting itself became controversial because some of the groups also receive financial support from drug makers that sell opioid painkillers.”