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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.
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