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CDC Offers Guideline for Chronic Pain Opioid Prescriptions

Recently, the Centers for Disease Control and Prevention offered draft guidelines for improving the way opioids are prescribed. The objective is to ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these powerful drugs.

The existing guidelines vary in recommendations, and primary care providers say they receive insufficient training in prescribing opioid pain relievers. It is important that patients receive appropriate pain treatment, and that the benefits and risks of treatment options are carefully considered.

Why is this important?

•  In 2012, health care providers wrote 259 million prescriptions for opioid pain relievers – enough for every American adult to have a bottle of pills.

•  Prescription opioid sales in the United States have increased by 300% since 1999, but there has not been an overall change in the amount of pain Americans report.

•  Almost 2 million Americans, age 12 or older, either abused or were dependent on opioid pain relievers in 2013.

•  In 2013, more than 16,000 people died in the United States from overdose related to opioid pain relievers, four times the number in 1999.

Several clinical practices have been addressed in the guideline including:

1. Determining when to initiate or continue opioids for chronic pain outside end-of-life care including:

    a. Selection of opioid therapy, non-pharmacologic therapy, non-opioid pharmacologic therapy

    b. Establishment of treatment goals

    c. Discussion of risks and benefits of therapy with patients

2. Opioid selection, dosage, duration, follow-up, and discontinuation including:

    a. Selection of extended-release and long-acting opioids

    b. Dosage considerations

    c. Duration of treatment for acute pain and chronic opioid use

    d. Considerations for follow-up and discontinuation of opioid therapy

3. Assessing risk and addressing harms of opioid use including:

    a. Evaluation of risk factors for opioid-related harms and integration into the management plan

    b. Review of prescription drug monitoring program data

    c. Use of urine drug testing

    d. Considerations for concurrent use of opioids and benzodiazepines

    e. Arrangement of treatment for opioid use disorder

If your case could benefit from a discussion about the new guidelines, please call us.

For a fact sheet from the CDC, please click here >>

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