The CDC issued the "CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016" on Tuesday. Here are six things to know about the new guidance and why it was issued now.
1. The prescription and sale of opioids has quadrupled since 1999, leading to an epidemic of opioid misuse and overdose. More than 40 people die daily from overdoses involving prescription opioids, according to the CDC.
2. Primary care providers account for roughly half of all opioid prescriptions, and the new guidelines are aimed at those clinicians prescribing opioids to managing chronic pain — not for opioid use in treating patients with active cancer, palliative care or end-of-life care.
3. To develop the guidelines, the CDC updated a 2014 systemic review of the effectiveness and risks of opioids and did a supplemental review on their benefits and harms, values and preferences, and costs. The agency also consulted with experts and listened to comments from the public and other partners.
4. There are 12 recommendations in all, including the following:
- Nonopioid therapy is preferred for the treatment of chronic pain, and opioids should only be used when benefits outweigh risk to the patient
- Before starting an opioid therapy, physicians should establish goals with the patient and consider how opioids will be discontinued
- Physicians should only prescribe the lowest effective dosage of an opioid when starting a new therapy and reassess risks of upping the dosage
- An opioid therapy should be revisited every three months, or more frequently, to evaluate harms and benefits of the regimen
5. The CDC plans to refine these guidelines when better evidence is available.
6. The CDC created materials, including a decision checklist, to help providers implement these recommendations. That toolkit is available here.
See the full recommendations here.