CDC Releases New Painkiller Guidelines To Curb Overdose Deaths

The Centers for Disease Control and Prevention announced new guidelines for opioid prescriptions that seek to curb what officials say is a growing epidemic of abuse and overdose deaths stemming from easy access to powerful painkillers like OxyContin, Percocet and Vicodin.

Among the recommendations:

• Weaker pain medication like Tylenol or Aspirin should be used first.
• When prescribed, medication should start at the lowest dosage possible.
• In most cases, less than three days worth of pills is sufficient, and more than seven days of pills “will rarely be needed.”
• Doctors should drug test patients and consider their overdose history before prescribing medication.

The recommendations are just that and not legally binding. But they represent a major concerted effort among the healthcare industry to fight an epidemic with staggering statistics.

A CDC press release announcing the guidelines said that prescription and sale of opioids has quadrupled since 1999 and that 40 Americans die each day from overdoses.

“Overprescribing opioids — largely for chronic pain — is a key driver of America’s drug-overdose epidemic,” CDC Director Tom Frieden said in the release. “The guideline will give physicians and patients the information they need to make more informed decisions about treatment.”

In all, the CDC’s guidelines include 12 requests about when the pain killers should be prescribed, how strong they should be and how to monitor patients before, during and after they take the drugs.

Physicians should discuss the risk of opioids with their patients, and they should only be used "if expected benefits for both pain and function are anticipated to outweigh risks to the patient," the CDC said.

Patients should take a urine test before the pills are prescribed and at least once a year after that, according to the CDC.

The guidelines were directed to primary care physicians, who the CDC says prescribe almost half of the opiates in the country.

The guidelines also have an exemption for people with cancer and people going through end-of-life care.

“Doctors want to help patients in pain and are worried about opioid misuse and addiction,” Debra Houry, director of CDC’s National Center for Injury Prevention and Control, said in the release. “This guideline will help equip them with the knowledge and guidance needed to talk with their patients about how to manage pain in the safest, most effective manner.”

Not everyone in the medical community was totally on board but many said it was a good step forward.

Some groups were worried that people in severe pain won't be able to quickly get the medicine they need. They also said that the guidelines are in conflict with some state laws, which Frieden said would take precedent over the CDC’s guidelines.

“While we are largely supportive of the guidelines, we remain concerned about the evidence base informing some of the recommendations, conflicts with existing state laws and product labeling, and possible unintended consequences associated with implementation, which includes access and insurance coverage limitations for non-pharmacologic treatments, especially comprehensive care, and the potential effects of strict dosage and duration limits on patient care,” the American Medical Association’s Patrice A. Harris said in a statement.

The American Academy of Pain Management offered similar thoughts.

“While CDC undoubtedly is well-intentioned, achieving this goal must be done in a way that does not harm the vast majority of people using opioids to manage their chronic pain–who have a positive risk/benefit ratio and who do not misuse or abuse their vital medications,” a statement from the academy’s executive director said.

“The Academy stands ready to work with anyone, including CDC, to implement education and policy advocacy efforts designed to bring about this appropriately balanced result.”

• Read the CDC’s full opioid guidelines here.