The Centers for Disease Control and Prevention (CDC) has issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. The CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 is designed to help primary care providers ensure safe and effective treatment in light of rising numbers of opioid addictions and overdoses.
“More than 40 Americans die each day from prescription opioid overdoses. We must act now,” said CDC director Tom Frieden, MD, MPH. “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 CDC defines chronic pain as pain lasting longer than 3 months or past the time of normal tissue healing. Primary care providers account for nearly half of all opioid prescriptions, treating adult patients for chronic pain in outpatient settings. Prescriptions and sales of opioids have quadrupled since 1999, though opioid prescriptions by dentists declined by 5.7% from 2007 through 2012.
With the guideline and other available online resources, physicians can determine if and when to start opioids to treat chronic pain. The guideline also offers information on medication selection, dosage, duration, evaluation, and discontinuation. Furthermore, it focuses on increasing the use of other effective pain treatments, including non-opioid medications and non-pharmacologic therapies.
For example, the guideline says that non-opioid therapy is preferred for chronic pain outside of active cancer, palliative, and end-of-life care. When opioids are used, it adds, the lowest possible effective dosage should be prescribed to reduce the risks of opioid use disorder and overdose. Also, providers should always exercise caution in prescribing opioids and monitor all patients closely.
“Doctors want to help patients in pain and are worried about opioid misuse and addiction,” said Debra Houry, MD, MPH, director of the CDC’s National Center for Injury Prevention and Control. “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.”