Will The New CDC Opioid Guideline Help Promote Addiction Treatment?

By John Lavitt 02/10/16

An early draft of the guideline has the CDC recommending providers take an evidence-based treatment approach when dealing with patients with opioid use disorder. 

Will The New CDC Opioid Guideline Help Promote Addiction Treatment?
Photo via Shutterstock

The Centers for Disease Control and Prevention (CDC) is working on releasing a new guideline for prescribing opioids for prescription pain. In an attempt to counteract problematic existing guidelines that vary in recommendations, the CDC teamed with the Substance Abuse and Mental Health Services Agency (SAMHSA) to develop the new guideline. The goal is to find a balance between making sure that patients receive appropriate pain treatment while, at the same time, the benefits and risks of such treatment options are carefully considered.

“It is important to note that, like other CDC guidelines, including prevention and treatment of sexually treated diseases, the guidelines are intended to support informed clinical decision-making but are not mandatory (that is, physicians are not required to follow these guidelines),” according to Courtney Lenard of the CDC’s press office. The CDC’s guidelines are meant to “help reduce use, abuse and overdose from these powerful drugs. The guideline is intended for primary care providers who treat adult patients (age 18 and older) for chronic pain in outpatient settings, and isn’t meant for patients who’re in active cancer treatment, palliative care or finish-of-existence care.”

The problem is obvious and extreme to anyone paying attention to the news. For example, in 2012 before the prescription painkiller crisis truly entered the national debate, health care providers wrote 259 million prescriptions for opioid pain relievers. Already, it was enough for every American adult to have a bottle of pills. Since 1999, prescription opioid sales in the United States have increased by 300%, despite the fact that there has not been an overall change in the amount of pain Americans report. Finally, to cap off the dark statistics, almost 2 million Americans, age 12 or older, either abused or were dependent on opioid pain relievers in 2013.

The Centers for Disease Control and Prevention (CDC) is also publishing a new guideline for prescribing opioids for chronic pain. Although the agency claims to be working for a timely release of the guideline, they seem to be behind the proverbial eight ball. They are bogged down in the bureaucracy of allowing for appropriate stakeholders in the debate to provide input while also facilitating partnership development to enhance dissemination and uptake of the guidelines. In other words, they are consulting with the pharmaceutical industry.

The CDC says it is using the Grading of Recommendations Assessment, Development, and Evaluation method to guideline development. This method uses a transparent approach to grading quality of evidence and strength of recommendations. Four factors were used to determine the recommendations: 1) quality of evidence, 2) balance between benefits and harms, 3) values and preferences, and 4) costs. At the same time, the CDC also has developed a tiered approach to involve stakeholders in guideline development. The identities of these stakeholders remain somewhat vague.

Please read our comment policy. - The Fix

Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles with his beautiful wife, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.