The Centers for Disease Control and Prevention announced new guidelines for prescribing opioids for chronic pain on March 15. The agency had announced preliminary guidelines, which were open to scrutiny, public comment and debate, in December 2015.
After receiving recommendations from its advisory committee, experts and the pharmaceutical industry, the CDC has finalized its guidelines.
“More than 40 Americans die each day from prescription opioid overdoses, we must act now,” CDC Director Tom Frieden said in a press release. “Overprescribing opioids — largely for chronic pain — is a key driver of America’s drug-overdose epidemic. The guideline will give physicians and patients the information they need to make more informed decisions about treatment.”
The guidelines are for prescribing opioids for chronic pain, not including patients receiving treatment for cancer, palliative or end-of-life care. Pain is considered chronic if it lasts at least three months or longer than the time it takes for normal tissue to heal.
Three principles shaped the CDC’s 12 guidelines:
Opponents of the guidelines include health care professionals and industry officials who believe the recommendations will make it more difficult for patients suffering from chronic pain to receive treatment.
“Doctors want to help patients in pain and are worried about opioid misuse and addiction,” said Dr. Debra Houry, director of the CDC’s National Center for Injury Prevention and Control, in a press release. “This guideline will help equip them with the knowledge and guidance needed to talk with their patients about how to manage pain in the safest, most effective manner.”
The CDC also developed tools for physicians to use when determining how to treat acute pain and chronic pain. Fact sheets, an opioid prescription checklist, a dosage calculator and other informational pamphlets are available online.
Opioid painkillers grew in popularity in the 1990s and following decades, eventually bringing in more than $2 billion in annual sales, according to the New York Times.
As the number of prescriptions for opioids like oxycodone and hydrocodone grew, so did the number of people abusing the drugs. The number of people visiting the emergency department or dying from opioid overdose steadily increased, eventually reaching record numbers in 2014.
Pharmaceutical companies were ordered to make the drugs more difficult to abuse, and the manufacturers eventually developed drugs that could not be crushed, snorted or injected.
Experts have speculated that increased measures to prevent prescription drug abuse have led to recent rises in heroin addiction and overdose. Heroin is an illicit opioid that can relieve symptoms of opioid withdrawal when abused. However, some studies denounce the link.
The CDC announced the new guidelines in a 50-page early release of its Morbidity and Mortality Weekly Report. The report was simultaneously published online in the Journal of the American Medical Association.
A summary of the guidelines:
Determining When to Initiate or Continue Opioids for Chronic Pain
Opioid Selection, Dosage, Duration, Follow-Up, and Discontinuation
Assessing Risk and Addressing Harms of Opioid Use