The Centers for Disease Control has proposed evidence-based clinical guidelines for prescribing opioids in primary care. These guidelines would support increased education of those who write these prescriptions, hopefully leading them to more judicious opioid prescribing. With these guidelines, the CDC is encouraging careful and thoughtful opioid prescribing by primary care practitioners treating patients with chronic pain. The CDC intended to release the opioid guidelines this month. CDC’s plan was effectively blocked by intense pressure from the opioid lobby, which sees more cautious opioid use as a financial threat. CDC was pressured into opening a federal docket on its draft guideline. This will tack months on to the process. It is also highly unusual- federal dockets are typically opened for public comment on proposed regulations, not for medical guidance issued by CDC. While opioids offer potential relief to many patients with pain and should remain an available and acceptable option to treat chronic pain in a limited manner, it is clear from prescribing data and related addiction treatment admission and overdose death data that the medical community has an overreliance on using opioids to treat pain. Changes are necessary to improve quality of life and prevent overdose deaths. At Las Vegas Recovery Center we admit people on high dose opioids, facilitate medically monitored withdrawal, and find that most patients have less pain off the opioids than when they were taking them. Families are devastated by the effects of chronic use of opioids and require serious assistance with their own recovery. Despite all of the problems related to the long-term use of opioids, between 1999 and 2008, sales of opioid pain relievers increased fourfold, while opioid-related substance use treatment admissions increased nearly six-fold and opioid-related overdose deaths nearly quadrupled. Despite the increase in opioid prescriptions, evidence indicates that 40 to 70% of people with chronic pain are not receiving proper medical treatment. An NIH panel recently concluded, “Together, the prevalence of chronic pain and the increasing use of opioids have created a ‘silent epidemic’ of distress, disability, and danger to a large percentage of Americans.” Furthermore, the latest epidemiological data on drug-poisoning deaths involving opioid analgesics and heroin released by the National Center for Health Statistics show that our nation’s epidemic of opioid misuse and related overdose deaths is worsening. Drug-poisoning deaths involving opioid analgesics increased 16% between 2013 and 2014, with 18,000 deaths in 2014. Also, overdose deaths related to heroin increased 28% during the same period. Clearly, we are not only failing to treat chronic pain appropriately, but we are failing to prevent the devastating consequences of opioid misuse. We are hopeful that these guidelines will be released as soon as possible to prevent further loss of lives. Join the conversation on Facebook and share your experience using acupuncture to relieve chronic pain.
