Recently updated CDC guidelines on prescription opioids have caused a stir among pain management doctors, clinics, and patients. It is hard to describe the updated guidelines as anything other than a change in course. Whether the course change is good or bad will be revealed over time.
The CDC published its original guidance on prescription opioids back in 2016. Their goal was to help stem the tide of the opioid crisis by encouraging doctors to be cautious about over-prescribing opioid painkillers. In essence, the CDC was telling doctors to stop recommending the medications unless absolutely necessary.
New guidance suggests the CDC believes pain management physicians have gone too far. Though the agency stresses the fact that the new opioid guidelines are voluntary, they are strongly urging doctors to be more compassionate toward patients whose best option for treating pain might be opioids.
It is hard to imagine the CDC was surprised by the backlash their new guidance created. In their defense, they are not throwing caution to the wind here. The updated guidelines represent more of a philosophy of not throwing the baby out with the bathwater.
A brief perusal of the opioid guidelines reveals that the CDC now recommends:
The CDC is also advising against abrupt discontinuation or rapid tapering if doing so presents a life-threatening situation for the patient. Under such circumstances, maintaining current dosage or more gradual tapering is preferred.
While the medical community does its best to implement the new guidance as practically and safely as possible, we would be wise to recognize that opioid pain medications have their pros and cons. Like any medical treatment, opioids need to be considered from multiple angles.
Knowing what we know about their addictive potential though, it still makes sense for pain management physicians to work with their patients in hopes of finding alternative treatments. If the benefits of an alternative treatment can help patients avoid opioids altogether, that seems to be the route to take.
Along those same lines, there is growing consensus among a small group of pain management doctors that simply masking pain with some sort of medication might be the wrong approach. Perhaps pain medications should be prescribed more to take the edge off than anything else. But of course, this is a topic still being debated within the medical community.
It's not yet clear how the CDC's new opioid guidelines will affect the majority of America's pain management clinics and physicians. The pain management specialty may ultimately embrace the guidelines fully and without question. Then again, there may be some legitimate concerns that need to be addressed.
One thing we can say for sure is that frank discussions between doctors and patients are still necessary. In fact, they are now probably more important than they were before. More relaxed CDC guidelines could encourage patients to ask for opioids more frequently. They could encourage doctors to prescribe them more frequently.
The decision to use opioid pain medications ultimately rests with doctor and patient. If you are a pain management patient, do not be afraid to ask questions to your pain management doctor. Don't be afraid to let your thoughts be known. You are your best advocate and the one who must make the final call on whether to use opioids.