“Next month will mark the one year anniversary of opioid guidelines released by the Centers for Disease Control and Prevention – guidelines that discourage primary care physicians from prescribing opioids for chronic non-cancer pain,” writes Pat Anson in the February 15, 2017 edition the Pain News Network newsletter.
My Expectations for CDC Opioid Guidelines One Year Ago
As I explained in my April 20, 2016 blog, Will the New Opioids Restrictions Help to Reduce Overdoses?, politicians and some government officials told us at the time that the new CDC opioid guidelines would reduce deaths due to overdoses. Based on the early evidence, I thought it was unlikely that the CDC’s guidelines would accomplish this goal. It was my belief that the guidelines would not help solve the opioid crisis. However, they would place people with pain at higher risk of suffering.
Unfortunately, I believed that under the CDC’s prescribing guidelines, pain patients would find it far more difficult to find doctors and pharmacists who would provide them with the medication they needed. People with pain would then have a choice between trying to endure their pain without adequate treatment, or finding illegal drugs such as heroin or fentanyl (the drug that killed pop singer Prince) on the streets.
In my blog, I said, “The problem is more complex than the lawmakers, CDC, and regulators would have us believe. Simply reducing the amount of opioids prescribed will not necessarily affect overdose death rates as you might expect. In fact, it might do just the opposite.”
My Concerns About CDC Opioid Guidelines Remain
Almost a year after the guidelines were implemented, my previous comments have eerily become true. We have seen roughly a 25% decline in opioid prescribing between 2012 and 2015. Hydrocodone short acting (SA) prescribing decreased 33% from 2011, and Methadone prescribing decreased 28% from 2010 – 2015. However, deaths from illegal opioids have continued to climb.
Yet we still have many unanswered questions. For example, as Anson asks in his Pain News Network article, “Are the CDC guidelines voluntary or mandatory?” The guidelines appeared to be voluntary, but state legislators are attempting to codify what were intended to be only guidelines.
In effect, healthcare professionals were asked to cut down on prescribing opioids without regard to the needs of individual patients. As I said in my blog, “Denying prescriptions to people who have been benefiting from opioids is a misguided attempt to save the lives of people with opioid addictions at the expense of people with pain.”
Outstanding Questions About CDC Opioid Guidelines
Other outstanding questions Anson raises about the CDC’s guidelines are: “Have they improved the quality of pain care? Are patients being treated with safer and better alternatives? Most importantly, are soaring rates of opioid abuse and addiction finally being brought under control?”
To get answers, the Pain News Network and the International Pain Foundation (iPain) have created a CDC survey. Anson explains that the survey is “intended to measure the impact of the guidelines on patients, doctors and other healthcare providers. We will be asking a series of multiple choice questions that should take you only a few minutes to complete.”
Link to CDC Survey for Patients and Healthcare Providers
As Barby Ingle, president of iPain and a Pain News Network columnist tells Anson, “I strongly believe that as these guidelines are implemented by doctors and hospitals around the country there are important lessons to learn from those who are affected by them….I hope that pain patients and providers participate in this survey so that we can begin to show how deep the impact actually is to the chronic pain community one year later.”
Because I share Ingle’s goals, I’m providing the link to the CDC survey here and asking patients, doctors, and other healthcare providers to consider completing it. I appreciate your participation and greatly value your input.
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Copyright 2017, Lynn Webster, MD