The U.S. federal government on Tuesday issued the first guidelines aimed at reducing prescription opiate abuse.
“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” said Centers for Disease Control and Prevention director Thomas Frieden. “We hope to see fewer deaths from opiates. That’s the bottom line. These are really dangerous medications that carry the risk of addiction and death.”
“We lose sight of the fact that the prescription opioids are just as addictive as heroin.”
The CDC guidelines are voluntary. The new guidelines include recommendations for when doctors should start or continue opioids for chronic pain. The CDC suggests doctors try non-opioid medications, such as acetaminophen or nonsteroidal anti-inflammatory drugs, before prescribing opiates.
Providers: CDC’s new Checklist for prescribing #opioids for chronic pain is a tool you can use in daily practice: https://t.co/qO9T5cTDxc.
— CDC (@CDCgov) March 15, 2016
At the heart of new CDC #opioid guideline is a conversation between clinicians & patients about best, safest treatment for chronic pain.
— Dr Brenda Fitzgerald (@CDCDirector) March 15, 2016
The CDC also implies opioids are preferred mainly for patients who have cancer or who are being treated for end-of-life care. If opioids do have to be used, the guidelines say, three days of treatment or less is often sufficient and more than seven days should rarely be required.
They also recommend doctors use more caution and closely monitor patients who are prescribed opioids.
One suggestion is urine drug testing. Another is that physicians use prescription drug monitoring programs, which currently exist in 49 states.
PDMPs are patient registries that allow doctors and pharmacies to see all controlled substances a patient is prescribed. However, participation in PDMPs is low and not all states require doctors or pharmacies to use them.
For patients who do become addicted, the new guidelines strongly recommend treatment with FDA-approved medications such as methadone, buprenorphine or naltrexone.
Another major suggestion is for doctors to avoid prescribing opioids and benzodiazepines – used primarily for anxiety and sleep disorders – at the same time.
Do No Harm: Read about new CDC Guideline for #Opioids and Chronic Pain @HuffPostImpact: https://t.co/veRZRUcYXZ
— Dr Brenda Fitzgerald (@CDCDirector) March 15, 2016
According to the CDC, the rate of deaths from drug overdoses has increased 137 percent since 2000.
This includes a 200 percent increase when it comes to deaths involving opioids — both prescription painkillers and heroin. According to CDC statistics, there were more opiod-related deaths recorded in 2014 than in any previous year.
(Image: Jonathan Ernst/Reuters)