CDC Proposes New Guidelines For Treating Pain And Opioid Use Disorder, Gives Doctors More Discretion

The Centers for Disease Control and Prevention (CDC) proposed new guidelines for prescribing opioid painkillers that encourage doctors to use their best judgment, removing its previous recommended ceilings on doses for chronic pain patients. This is the first comprehensive revision of the agency’s opioid prescribing guidelines since 2016.

“The overall thrust of the recommendations was that doctors should first turn to 'nonopioid therapies' for both chronic and acute pain, including (...) ibuprofen, as well as physical therapy, massage, and acupuncture,” reported The New York Times.

“It’s a total change in the culture from the 2016 guidelines,” said Dr. Samer Narouze, chairman of the Center for Pain Medicine at Western Reserve Hospital in Ohio, characterizing the earlier edition as ordering doctors to “just cut down on opioids — period.”

The new proposal, continued Dr. Narouze, “has a much more caring voice than a policing one, and it’s left room to preserve the physician-patient relationship.”

The recommendations are open on the Federal Register for public comment for 60 days. “We are welcoming comments from patients who are living with pain every day and from their caregivers and providers,” Christopher Jones, acting director of the National Center for Injury Prevention and Control told the Times.

Although the 2016 guidelines were merely a recommendation, doctors “misapplied them as rigid standards, tapering chronic pain patients. The new guidelines have flexibility to recognize that pain care needs to be individualized,” Dr. Jones said.

The new guidelines compare the relief provided by opioids to that offered by exercise, and other substances and endorse treatments such as heat therapy and weight loss, yoga, tai chi, qigong, massage and acupuncture.

Along a similar track, the Food and Drug Administration (FDA) announced Wednesday that it is taking similar steps aimed at fostering the development of non-addictive alternatives to opioids to manage acute pain and prevent new addiction.

The agency issued draft guidance to provide recommendations to companies developing non-opioid analgesics for acute pain. While the FDA does not mention cannabis as an alternative, there is a growing body of research, which looks at its therapeutic properties that can help people recover from addiction as well as alleviate pain.

Photo by Myriam Zilles on Unsplash.