“The new CDC guidelines and as well as our state guidelines are asking for things like a plan to deal with this pain other than opioids, a plan to get off opioids, screening for past addictive behavior”, says John Horsley, director of addiction services at Oaklawn.
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The new guidelines recommend nonopioids, including acetaminophen and ibuprofen, as preferred therapy for chronic pain unless patients have active cancer or are receiving palliative or end-of-life care. The guidelines are part of a growing backlash against practices developed two decades ago, when doctors across the country began prescribing opioids for routine pain amid claims by pharmaceutical companies and some medical experts that they could be used to treat common conditions like back pain and arthritis without addiction.
When prescribed, the CDC says doctors should use the lowest effective dose of immediate release opioids, rather than extended-release or long-acting ones. “Physicians are partners in the fight against opioid addiction and these new recommendations will provide a critical resource for primary care providers as they encounter patients struggling with pain management”. They do not apply to cancer patients or people who are in end-of-life-care. Much of the advice is geared for primary care physicians, who prescribe almost half of the opioid painkillers in the United States.
If you suffer from chronic pain, expect a different conversation with your doctor the next time you go for a prescription refill. “I have pushed for the release of these guidelines because I have seen firsthand the devastating effects of prescription drug abuse on individuals, families, and communities in West Virginia”. This rate could increase if doctors continue to prescribe opioids without following the new guideline.
“Plainly stated, the risks of opioids are addiction and death and the benefits for chronic pain are often transient and generally unproven”, Frieden said. The same year also saw over 10 million Americans using prescription opioids for non-medical reason while nearly 2 million individuals over 12 years old can be considered to have opioid substance use disorder.
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LA Times reports that since the late 1990’s, more than 160,000 people in the U.S. have died from fatal opioid overdose. The guideline also offers specific information on medication selection, dosage, duration, and when and how to reassess the patient’s progress and discontinue medication, if necessary. As the CDC writes, “In a systematic review, opioids did not differ from nonopioid medication in pain reduction, and nonopioid medications were better tolerated, with greater improvements in physical function”.
