Of the 12 recommendations in the agency’s guidance, the most prominent is the suggestion that doctors refrain from giving opioid prescriptions for chronic pain-the drugs are OK to use for palliative care, cancer patients, and end-of-life treatments.
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“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.
Some doctors and experts are concerned the guidelines will endanger effective treatment for patients who actually benefit from opioids, but the CDC said doctors should curtail use while basing decisions on individual conditions.
The guideline, which was presented for public comment in December 2015, is limited to prescribing in outpatient primary care settings for chronic pain lasting longer than three months and not in the context of palliative care. They do not apply to cancer patients or people who are in end-of-life-care. According to CDC stats, the rate of drug overdose deaths from prescription opioids and heroin tripled between 2000 and 2014.
The recommendations issued by the federal Centers for Disease Control and Prevention are part of the government’s response to an epidemic of overdose deaths. “Having clear rules of the road to guide prescribing practices will help physicians better understand the risks associated with prescription opioids and determine the best treatment for chronic pain management”, said Capito. If they prescribe opioids, the CDC suggests first giving the minimum dose and to prescribe only three days’ worth of pills.
The guidelines direct clinicians to discuss the risks of opioid medication with patients and to only continue opioid therapy if there is a meaningful improvement in a patient’s pain, which outweighs the risk of addiction.
To combat the threat of an opioid epidemic, the CDC urged physicians to limit their prescription of various opioids because of the increasing risks of taking the drugs.
Prescription opioid overdoses kill 52 people every day. The guideline also offers specific information on medication selection, dosage, duration, and when and how to reassess progress and discontinue medication if needed.
In the past several years, the use of opiates, including heroin, has increased with hundreds dying across CT from fatal overdoses.
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The agency says doctors should first look to use non-pharmacologic, or at least nonopioid, treatment for chronic pain.
