CDC opioid prescribing guidelines clarified

In a letter released in April, the CDC clarified its Guideline for Prescribing Opioids for Chronic Pain, stating that they weren’t meant to be unduly restrictive for chronic pain patients. The letter came in response to repeated concerns from healthcare societies, providers, and experts.

The clarification says that physicians are encouraged to use their best judgment when prescribing opioids. In addition, the guideline is not meant to deny appropriate opioid therapy to anyone suffering from conditions such as cancer and sickle cell disease.

“The Guideline is not intended to deny any patients who suffer with chronic pain from opioid therapy as an option for pain management,” wrote CDC Chief Medical Officer Deborah Dowell, MD, MPH. “Rather, the Guideline is intended to ensure that clinicians and patients consider all safe and effective treatment options for patients.”

She also said that they’ll revisit the guideline as new evidence and prescription recommendations become available.

“Chronic pain is common and multidimensional, and patients deserve safe and effective pain management. … CDC will continue to emphasize what the Guidelines and associated materials say about communication, patient engagement in decision-making, and maintenance of the patient-provider relationship,” wrote Dowell.  

The CDC’s letter was addressed to the leaders of three medical organizations—the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the American Society of Hematology (ASH). These groups have been pushing the CDC for clarification on how the guideline applies to cancer patients, cancer survivors, and people with sickle cell disease. For the three organizations, the CDC’s response was cause for celebration. 

“Pragmatic approaches for pain management exist at the intersection of multiple health concerns,” wrote NCCN CEO Robert W. Carlson, MD, in the press release. “Our guidelines help clinicians to assess the risk of inappropriate substance use, while still ensuring people with cancer don’t suffer unnecessary, severe pain. CDC’s acknowledgement that clinical decision-making should be based on the relationship between physicians and their patients is important and in the best interest of people with cancer and sickle cell disease.”

More about this will be in the June edition of Patient Safety Monitor Journal