CDC urges doctors to curtail opioid use

The Centers for Disease Control and Prevention (CDC) on Tuesday released new guidelines for prescribing opioids, a long-awaited step aimed at curbing the nation’s drug abuse epidemic.

The CDC guidelines caution doctors against prescribing opioids to relieve chronic, long-term pain. For the “vast majority” of patients, CDC Director Tom Frieden said, the risks of prescribing such drugs “will outweigh the benefits.” 

{mosads}“More than 40 Americans die each day from prescription opioid overdoses. We must act now,” Frieden said. “Overprescribing opioids — largely for chronic pain — is a key driver of America’s drug-overdose epidemic.” 

The action from the CDC comes after years of study within the organization, and in the middle of a presidential race where opioid abuse has become a major issue.

During this year’s primaries in New Hampshire, candidates from both parties spoke out on the issue, and New Jersey Gov. Chris Christie delivered a speech that went viral online about the need to treat addiction as a health problem.

There are now more deaths from drug overdoses in the United States every year than there are from car crashes. Most of the drug overdose deaths, about 28,000, are from opioids. 

Hillary Clinton in September rolled out a $10 billion plan to partner with states on a range of steps including investing in treatment infrastructure like community health centers. 

“In state after state, this issue came up again and again — from so many people, from all walks of life, in small towns and big cities,” Clinton wrote in a New Hampshire Union Leader op-ed.

The Senate last week passed a bill that authorizes funding for programs to combat prescription opioid abuse, in addition to increasing the availability of naloxone, a drug to treat overdoses.

The legislation did not include any funding, but Congress in December passed a spending bill that included more than $400 million to fight opioid abuse.

The new CDC guidelines stress that other methods of treating pain should be preferred to opioids. When the drugs are used, it should be in the lowest possible doses, the agency said.

Because the starting point for opioid use is often a short-term need for acute pain, the guidelines caution that three days or fewer of the drugs is often enough and more than seven days “will rarely be needed.”

The guidelines also call for doctors to review databases to make sure patients are not already receiving opioids elsewhere and to use urine testing to check for drugs before beginning a prescription. 

The recommendations have been controversial amid some concerns that they would interfere with doctors’ decision-making. 

The American Medical Association said in a statement that it is “largely supportive” of the guidelines, but warned of “the potential effects of strict dosage and duration limits on patient care.”

Frieden stressed that the final decision on prescribing drugs will remain with doctors. The guidelines are nonbinding. 

The role of pharmaceutical companies in encouraging the growth in opioid prescribing is also contentious. 

In 2007, Purdue Pharma, the company that makes OxyContin, pleaded guilty to misleading the public about the addictive dangers of its drug. 

Frieden said the CDC was careful not to involve anyone with a conflict of interest with pharmaceutical companies in the development of the guidelines.