March 17, 2016

CDC Acknowledges Need for Integrated Pain Treatment but Places Limits on Physician-led, Medically Necessary Opioid Treatment

WASHINGTON, March 17, 2016 – Today, the Alliance for Balanced Pain Management (AfBPM) made the following statement on the newly-released opioid guidelines from the Centers for Disease Control and Prevention (CDC), which embrace integrated pain care but overstep on the issue of prescription opioid treatment, potentially undermining physicians and patients’ ability to treat pain.

The CDC’s guidelines advise avoiding opioid doses of 90 morphine milligram equivalents or more and limiting treatment to no more than 7 days. The agency also encourages doctors to use immediate-release, rather than long-acting, formulations when prescribing opioids. Though intended as advice, guidelines such as CDC’s sometimes become codified as state laws and incorporated into health plan policies, posing access and coverage restrictions for patients.

The guidelines do acknowledge the need for integrated pain care, noting the value of non-pharmacologic approaches such as exercise and talk therapy, and non-opioid pain treatments, such as epidural injections, certain antidepressants and NSAIDs like acetaminophen. The CDC advises these options as both alternatives to opioid therapy and complements to opioid therapy when it’s deemed necessary. The guidelines also debunk the myth that opioid-only treatment is cheaper than long-term, multi-faceted approaches to pain.

In addition to guidance on prescribing, the CDC also encourages safety measures such as using prescription drug monitoring programs and potentially offering patients naloxone, the opioid overdose antidote.


“The Alliance for Balanced Pain Management agrees that primary care doctors prescribing opioids should proceed cautiously and discuss all possible risks with patients. But when the CDC suggests the exact number of days and the precise dosing limit, the agency may be inserting itself too far, interfering with physician care of patients who live day to day with serious pain. These guidelines mark a milestone in the national conversation about how we treat pain, both chronic and acute. Multimodal approaches to pain treatment make use of non-opioid treatments and have tremendous value for patients, but we shouldn’t tie physicians’ hands when it comes to treatment options.”

For more information, visit the Institute for Patient Access Policy Blog HERE.


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