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CDC releases guidelines for prescribing opioids for chronic pain

The Center for Disease Control (CDC) released voluntary guidelines for prescribing opioids for chronic pain. The guidelines urge primary care physicians to try measures like physical therapy, exercise, complementary/alternative therapies, behavioral therapies, and over-the-counter pain medications before prescribing opioids for patients with chronic pain.

These guidelines pertain to patients 18 years and older, who are in primary care settings. They focus on treatment of chronic pain, wherein chronic pain is defined as pain lasting longer than three months. The CDC suggests, that opioids should not be the first choice of treatment for ailments like back pain. Apart from this, it is recommended by the CDC that physicians limit opioid treatment to 3 days for short-term pain. The CDC also wants physicians to prescribe the lowest effective dose possible for pain relief and only continue prescribing these medications if patient shows improvement in pain.

The CDC suggests some extra measures for people who have been prescribed opioids. These include, taking them as directed by your physician, regular monitoring including more frequent visits to the doctors, a pain treatment plan, being aware of the side-effects, and urine testing.
The guidelines exclude patients being treated for cancer-related pain, palliative care, or end of life care.

The guidelines come in light of increasing scrutiny over deaths associated with prescription opioids. (In 2014, more than 28,000 people died of opioid overdose1)

You can view the complete guidelines here: http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm

What do you think of the new guidelines? Do you anticipate that the guidelines will impact you directly?

  1. http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm

Comments

  • Kathy P.
    3 years ago

    I think forcing patients to constantly go in, get urine tested, bring in unused pills, etc. is just ridiculous, and puts undue burdens on chronic pain patients. We have enough hoops to jump through just getting our maintenance meds with our insurance companies and doctor’s offices. It definitely doesn’t help that insurance companies are dictating to doctors which meds they can or can’t prescribe. These are not “controlled substances” but regular maintenance medications for chronic conditions such as blood pressure, heart, COPD, kidney and statins.

    My doctors have had to call the insurance company(ies) to fight with them to prescribe the medications they want me to have. The insurance companies want them to try cheaper alternatives (did that), go up through the tiers (did that) and maybe they want to prescribe this or that, even though the patient has had a severe allergic reaction to it.

    For starters, we need to get the insurance companies and pharmaceutical companies out the advisory arena for CDC. I won’t even go into the politics.

    Patient education would be a blessing. Specific advice about what the risks are, how risks are increased, side effects, how to self-monitor and when to call your physician, would help a lot. There are even pill safes that only unlock at certain time intervals, which might be considered for those that have memory problems, children and those that have *demonstrated* high risk behavior. It certainly would be a less expensive means of getting some control of the problem.

    I hope this one is quickly put aside in favor of more reasonable and less expensive methods of control.

  • Carla Kienast
    3 years ago

    I can only think of people who, like my brother, suffer from intense pain to the point of immobility. He is confined to a wheelchair and, being alone, is dependent on the kindness of friends to drive him many miles to see his doctors. Depriving him of the only medication that brings him any relief or making it even more difficult to obtain is cruel and unusual punishment. I can only imagine the pain of the 28,000 people who died in 2014 due to opiods. However, these guidelines offer no assurance of addressing these statistics while they have every indication of impeding those who desperately need the drugs.

    I do not want to diminish the terrible toll of the 28,000 deaths, but when numbers are used to make a statement, I think it is important to put them in context. Below are the cause-of-death statistics for 2014 from the CDC’s website. Opoid-related deaths don’t make the list. In the interest of saving the most lives with the limited resources afforded the CDC, perhaps they should concentrate their efforts on one of these causes that claimed the lives hundreds of thousands of Americans in 2014. http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

    •Heart disease: 611,105
    •Cancer: 584,881
    •Chronic lower respiratory diseases: 149,205
    •Accidents (unintentional injuries): 130,557
    •Stroke (cerebrovascular diseases): 128,978
    •Alzheimer’s disease: 84,767
    •Diabetes: 75,578
    •Influenza and Pneumonia: 56,979
    •Nephritis, nephrotic syndrome, and nephrosis: 47,112
    •Intentional self-harm (suicide): 41,149

  • Mschell
    3 years ago

    The state I live in has pretty much adhered to such guide lines already. So I don’t feel there will be any changes in my care.I don’t like having to go to “pain management” or the cost. People can be so cruel if they know your connected to one of those clinics! And at first I was troubled having to submit urinalysis.
    I felt criminalized & degraded. Now I just hate, no resent having to pay for testing I really can’t afford. O don’t believe for one minute that the heroin epidemic is
    the result of pain medications being
    prescribed for chronic pain. Drs just don’t prescribe opiates
    that freely. It’s been my experience that over the counter analgesics
    Heat or ice along 28th other meds 1st. If the pain is so intense that opiates are prescribed than it starts with the lowest dose & go from there. So I can’t see where all the hype is coming from. There will always be people who abuse substances. It’s really insured I think to blame the
    medications.

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