We previously communicated with you about the current epidemic of dependence, abuse, and deaths that have occurred over the past two decades with the concomitant rapid increase in opioid prescriptions and advised you that the Centers for Disease Control and Prevention (CDC) was recommending stricter guidelines for prescribing pain killers, including the expanded availability of and wider access to naloxone, an antidote for opioid-related overdoses.

The CDC recently issued guidelines for prescribing opioids for patients with chronic pain. The guidelines recommend that physicians should try to avoid addictive opioid painkillers whenever possible for patients with most forms of chronic pain, such as patients suffering from joint or back pain, dental pain, or other chronic pain treated in an outpatient setting. This recommendation does not include the use of narcotic painkillers for people dealing with cancer-related pain or terminally ill patients in palliative care.

The guidelines also state that physicians should try non-opioid therapies first before turning to opioids for chronic pain. If it is determined that opioids are needed, the physician should start patients on immediate-release drugs and not the extended-release or long-acting versions. For acute pain, treatment of up to three days is often sufficient and more than seven days is rarely needed according to the CDC.

The CDC plans to work with federal partners and payers on policies that could help improve implementation of the guidelines, such as strengthening the coverage of non-drug pain treatments, urine drug testing, or medication-assisted treatment for opioid addiction. The agency said it will update the guidelines as new evidence becomes available.

You can read the CDC's complete report on prescribing opioids for chronic pain here.