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CDC releases new opioid prescribing guidelines



The US Centers for Disease Control on Friday released its revised opioid prescribing guidelines with new recommendations for providers that emphasize better communication with patients and that opioids should not be on the front lines of managing pain.

The last time the CDC released opioid guidelines was in 2016, which triggered what many saw as sharp reductions in painkiller prescribing and a slew of laws and other regulations that left pain undertreated and unmanaged, according to experts. The CDC document said some of the 2016 recommendations resulted in “misuse” of strategies to limit opioid prescribing and, in some cases, abrupt discontinuation of opioids that jeopardized patients̵

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The CDC said the new recommendations “aim to improve communication between physicians and patients about the benefits and risks of prescription opioids and other pain management strategies; improve the safety and effectiveness of pain management; improve pain, function, and quality of life for people with pain; and reduce the risks associated with treatment of opioid pain (including opioid use disorder, overdose and death) and with other pain management.”

The recommendations address tapering for patients who have been on long-term opioid therapy, urging physicians to use a slow approach to lowering medication strengths and doses: “If the benefits outweigh the risks of continued opioid therapy, physicians should work closely with patients to optimize non-opioid therapies. while you continue opioid therapy If the benefits do not outweigh the risks of continued opioid therapy, physicians should optimize other therapies and work closely with patients to gradually taper to lower doses or, if warranted based on the patient’s individual circumstances, appropriately taper and discontinue opioid therapy . Unless there are indications of a life-threatening problem such as warning signs of impending overdose (eg, confusion, sedation, or slurred speech), opioid therapy should not be abruptly discontinued and physicians should not rapidly reduce opioid doses from higher doses.”

Among the recommendations, the CDC said that non-opioid therapies “are at least as effective as opioids for many common types of acute pain” and that physicians “should maximize the use of non-pharmacologic and non-opioid pharmacologic therapies.”

For chronic pain, the CDC states that non-opioid therapies are “preferred” and that before starting opioid therapy for subacute or chronic pain, “physicians should discuss with patients the realistic benefits and known risks of opioid therapy, should work with patients to establish treatment goals for pain, and function, and should consider how opioid therapy will be discontinued if the benefits do not outweigh the risks.”


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