CDC issues new opioid pain guideline; advocates call for implementation

Abstract

When the federal Centers for Disease Control and Prevention (CDC) first issued its opioid prescribing guideline for pain in 2016, many in the addiction treatment field didn't think physicians would do what the agency — which has no enforcement authority and doesn't govern physician practice — was recommending: a limit for the amount and duration of opioids to be prescribed for pain (see CDC issues draft opioid prescribing guidelines for chronic pain, ADAW Dec. 21, 2015; https://onlinelibrary.wiley.com/doi/10.1002/adaw.30424). What happened was a broadscale reduction in access to opioids for pain, causing significant suffering (see Chronic pain patient stories: Withdrawal, pain and fear, ADAW Jan. 15, 2018; https://onlinelibrary.wiley.com/doi/10.1002/adaw.31822). Physicians, it turned out, were afraid of what the Drug Enforcement Administration (DEA) — which certainly does have enforcement authority — and state medical boards — which could take away medical licenses — would do. So many physicians tapered, and even abandoned patients who not only needed opioids for pain, but had become dependent on them, subjecting their patients to both massive increases in pain and withdrawal at the same time. Some committed suicide. At the same time, opioid overdose deaths — which the CDC had mistakenly thought would decrease as a result of reducing access to opioids for pain — continued to increase.