Trying to curb widespread opioid abuse that claimed nearly 20,000 U.S. lives last year alone, the Centers for Disease Control and Prevention (CDC) is telling primary care clinicians to prescribe treatments other than opioids for chronic pain outside of active cancer treatment, palliative care and end-of-life care.
The new CDC opiod prescription guidelines are intended for use outside of acute care settings.
A Special Communication from the CDC published online in the Journal of the American Medical Association (JAMA) outlines 12 recommendations divided into three categories.
They are:
Determining when to initiate or continue opioids for chronic pain:
Opioid selection, dosage, duration, follow-up and discontinuation:
Assessing risk and addressing harms of opioid use:
A companion commentary in JAMA contends that part of the problem is that doctors aren't well trained about addiction either in medical school or in continuing education. It also cites "enormous gaps in reimbursement" for both chronic pain and addiction treatment.
"The CDC guideline for prescribing opioids for chronic pain is an important and essential step forward," it says. "With support from physicians across the country, as well as from policy makers at all levels, implementation of the recommendations in this guideline has the potential to improve and save many, many lives."
Just last month the American Medical Association issued its own suggested changes for practitioners to tackle the opioid addiction crisis, as FiercePracticeManagement reported. Like the CDC, the AMA recommended clinicians use PDMP data routinely.
As the CDC notes in its new guidelines, primary care clinicians can help avert possible abuse by communicating with patients before prescribing opioids to learn about any personal or family history of addiction, and to determine whether patients even want opioid painkillers, FiercePracticeManagement previously reported.
To learn more:
- here's the guideline
- read the JAMA Special Communication
- check out the commentary