The Centers for Disease Control and Prevention has softened its recommendations for doctors prescribing opioid painkillers, giving providers more flexibility in the way they prescribe the drugs to treat short- and long-term pain.
The new guidance backs off from the agency’s 2016 recommendations that encouraged doctors to avoid prescribing opioids to treat patients’ pain and put more barriers in place. It eliminates caps on numerical dose thresholds and time limitations on opioid treatment for acute pain.
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“The science on pain care has advanced over the past six years,” said Dr. Debbie Dowell, chief clinical research officer for the CDC’s Division of Overdose Prevention. “During this time, CDC has also learned more from people living with pain, their caregivers, and their clinicians. We’ve been able to improve and expand our recommendations by incorporating new data with a better understanding of people’s lived experiences and the challenges they face when managing pain and pain care.”
The increase in prescription opioids, such as oxycodone and morphine, which can be highly addictive, was a large driver for the surge in drug overdoses in the U.S. over two decades ago, contributing to the current opioid crisis. In 2016, 40% of the 42,000 opioid overdose deaths involved a prescription opioid.
In more recent years, illicit fentanyl and other drugs have overtaken prescription opioids, accounting for more deaths.
Among the new guidelines, the CDC is no longer recommending that doctors limit opioid therapy for acute pain to three days and has removed a suggestion that providers avoid upping a person’s opioid dosage to the equivalent of 90 milligrams of morphine a day. The agency also advised that physicians not cut patients off the prescriptions, instead reducing their dosage slowly, unless there are life-threatening circumstances.
The guidance noted that physicians should consider non-opioid treatments for acute pain, which is typically defined as pain lasting a month or less, and, when prescribing opioids, to consider immediate-release versions versus long-acting ones, which have more short-term effects.
The CDC said the updates are based on new data and meant to reduce the inadvertent harms related to when a patient’s opioid treatment is abruptly ceased or severely tapered.
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The American Pharmacists Association applauded the agency for the updated guidelines, saying that it will “go a long way toward curbing the unintended consequences of the past.”
