CDC’s new Guideline for Prescribing Opioids for Chronic Pain has been published in the Morbidity and Mortality Weekly Report Recommendations and Reports, and it offers recommendations to improve patients’ safety and care for those with chronic pain while addressing the prescription opioid overdose epidemic. From 1999 to 2014, more than 165,000 people in the United States died from overdoses related to prescription opioids, according to the agency, which reports that prescribing and sales of opioids have quadrupled since 1999 “without a change in the amount of pain Americans report.” The guideline is intended for primary care providers who are treating adult patients for chronic pain — and not for active cancer treatment, palliative care, and end-of-life care. Its recommendations include:
- Non-opioid therapy is preferred for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.
- When opioids are used, providers should prescribe the lowest effective dosage.
Providers should work with patients to establish pain treatment goals, check for improvements in pain and function regularly, and taper or discontinue opioids if a patient experiences harm. The guideline addresses: 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
Occupational Health & Safety News, 16 March 2016 ;http://www.ohsonline.com ;