As part of the urgent response to the epidemic of overdose deaths, the Centers for Disease Control and Prevention issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care.
The CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 will help primary care providers ensure the safest and most effective treatment for their patients.
The United States is currently experiencing an epidemic of prescription opioid misuse and overdose. Increased prescribing and sales of opioids — quadrupling since 1999 — helped create and fuel this epidemic.
“In the last 15 years, deaths from opioids have quadrupled and if you just look at the year 2014, there were 28,000 people that had overdose deaths from opioids,” said UNMC’s Tom Tape, M.D., a member of the Core Expert Group that advised the CDC in regards to the guideline. “Over half of those were from prescription opioids, so the prescriptions we’re writing are a big part of the problem.”
While prescription opioids can be part of effective pain management, they have serious risks. The new guideline aims to improve the safety of prescribing and curtail the harms associated with opioids, including opioid use disorder and overdose.
The guideline also focuses on increasing the use of other effective treatments available for chronic pain, such as nonopioid medications or physical therapy.
“Chronic use of opioids carries a risk of overdose death,” Dr. Tape said. “Most of the time it’s totally accidental. Some of the time the overdose occurs because the opioids are mixed with alcohol or other drugs that cause sedation and cause a person to stop breathing.”
By using the guideline, primary care physicians can determine if and when to start opioids to treat chronic pain. The guideline also offers specific information on medication selection, dosage, duration, and when and how to reassess progress and discontinue medication if needed. Using this guideline, providers and patients can work together to assess the benefits and risks of opioid use.
“The usages of these drugs have increased because physicians have had a lot of attention drawn to the desire to control pain better,” Dr. Tape said. “Doctors need to discuss with their patients the risks, as well as the potential of using these medications, and we need to have a strategy to assess whether they’re helping the patient improve not only their pain, but also their function.”
My mother was given opioids in the hospital, and it threw her into a-fib, she hallucinated among other effects. We tried to tell the hospital staff what was happening (they have this same effect on my brother, he's the one that told us to have the staff stop giving her anything narcotic/opioid based as it could potentially kill her) and to stop giving her the stuff, but they wouldn't listen and said there was no way to record in her chart the reactions she was having (????????). Thank you for your work in this area.