Hold Off on Opioids for Chronic Pain Treatment, CDC Says

The prescription opioid epidemic is a major problem, to say the least, and the number of overdoses has quadrupled since 1999. The Centers for Disease Control and Prevention (CDC) recently released new guidelines designed to reduce prescription opioid misuse and abuse.

“More than 40 Americans die each day from prescription opioid overdoses, we must act now,” CDC Director Tom Frieden, MD, MPH, said in a media telebriefing. “Overprescribing opioids — largely for chronic pain – is a key driver of America’s drug-overdose epidemic.”

Using scientific evidence and expert insight, the new guidelines consist of 12 recommendations for the treatment of chronic pain that is not associated with cancer or palliative or end-of-life care. The first recommendation suggests that nonpharmacological and nonopioid pharmacological approaches be used before moving on to prescription opioids.

• Related: Opioid Addiction and Patient Care: Jose Contreras from HackensackUMC

Additional takeaways from the guidelines say that healthcare providers should:

• Establish treatment goals before opioid therapy begins
• Use urine drug testing before prescribing opioids
• Prescribe the lowest effective dosage
• Evaluate benefits and harms one to four weeks after starting therapy

The guidelines also suggest that when a patient is first starting on opioids, providers should prescribe immediate-release as opposed to extended-release.

“This guideline will help equip them with the knowledge and guidance needed to talk with their patients about how to manage pain in the safest, most effective manner,” said Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control.

The CDC provided a decision checklist for clinicians for prescribing painkillers. The full report and guidelines can be found here.

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