CDC Releases New Painkiller Prescriptions Guidelines
By SMART Health Claims
Guidelines encourage non-opioid therapy as the preferred method of chronic pain treatment to combat growing, national opioid epidemic
The Centers for Disease Control and Prevention (CDC) issued new voluntary guidelines for prescribing opioid medications for chronic pain, in response to America’s rampant prescription drug crisis. Twelve recommendations were developed for primary care providers, who account for prescribing nearly half of all opioid prescriptions, to offer patients alternative treatments for pain, such as non-addictive, non-opioid painkillers and physical therapy.
The CDC emphasizes that non-opioid therapy is the preferred treatment method for patients in chronic pain, but clarifies that the guidelines are not intended for approaching the treatment of patients in active cancer treatment, palliative care, or end-of-life care.
Highlights of the new guidelines include:
Know the Risks and Establish Treatment Goals: If benefits of opioids do not outweigh the clear risks, clinicians and patients should consider how opioids will be discontinued.
Prescribe in Terms of Duration: If opioids are prescribed, the guidelines suggest prescribing immediate-release medications over long-term release medications. Specifically, avoiding the use of immediate-release opioids in combination with long-acting opioids is preferable.
Prescribe the lowest effective dosage: Clinicians should start at the lowest possible dosage and increase with caution in very small amounts.
If Opioids are Prescribed, Evaluate Patients Frequently: Patients who are prescribed opioids should be evaluated within 1 to 4 weeks of starting opioid therapy of dose escalation. This should be continued at least every 3 months or more frequently.
Review Patient History: Clinicians should check for a history of controlled substance abuse or if a patient may be taking another drug that could have a negative interaction with the prescribed opioid.
The opioid epidemic is widely considered to be the worst public health crisis in decades. According to a recent article in the New York Times, the guidelines were inspired by growing criticism of opioid prescribing practices for common conditions that began more than 20 years ago. Opioids now account for the deaths of 44 Americans every day.
“If you’re prescribing an opiate to a patient for the first time, that’s a momentous decision,”CDC Director Tom Frieden said in an interview. “That may change that patient’s life for the worse forever. So you’ve really got to think carefully before doing it.”
Opioid Abuse: A Snapshot of the Facts
Opioid painkillers like OxyContin, Percocet and Vicodin have become the most widely prescribed drugs in the country, with sales of nearly $2 billion a year - IMS Health
In 2014,opioids killed more than 47,000 people, which exceeds the 32,000 who died in road accidents
259 million painkiller prescriptions were written by health care providers in 2012, enough for every American adult to have a bottle of pills
99 percent of the world’s hydrocodone is consumed by U.S. patients, as is 80 percent of the world’s oxycodone and 65 percent of the world’s hydromorphone
Of the 9.4 million Americans who take opioids for long-term pain, 2.1 million are estimated by the National Institute of Health to be hooked and are in danger of turning to the black market
4 out of 5 heroin addicts say they came to the drug from prescription painkillers
Effects of Prescription Guidelines at Local Level
Local health providers at public health clinics, university health clinics, and community health centers are tasked with leading the effort to combat the devastation from opioid abuse and subsequently, heroin abuse, Hepatitis C and HIV. The CDC prescription guidelines, while long-term, address the root cause of the opioid epidemic and are a positive step toward reversing the trend in America’s communities.
In previous coverage, we discussed the magnitude of prescription drug abuse and provide strategies to deal with the issue. Learn more and join the discussion here: