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  • Washington Highlights

    CDC Issues Updated Guideline for Prescribing Opioids


    Gayle Lee, Director, Physician Payment & Quality

    The Centers for Disease Control and Prevention proposed a opioid prescribing guideline on Feb. 10 that update and expand the agency’s 2016 Guideline for Prescribing Opioids for Chronic Pain. The guideline provides recommendations for primary care physicians, as well as for outpatient clinicians in other specialties, who are prescribing opioids for acute, subacute, and chronic pain outside of active cancer treatment and palliative and end-of-life care.

    The guideline addresses (1) when to initiate or continue opioids for chronic pain, (2) opioid selection, dosage, duration, follow-up, and discontinuation, and (3) assessing risk and addressing harms of opioid use. Among the changes, the draft guideline no longer includes specific dosage ceilings, which were often misinterpreted and could be harmful for those suffering from pain.  In addition, it no longer suggests that opioid treatment for acute pain be limited to three days. Also, physicians would be advised to start patients off on low doses of immediate-release pills. The updated guideline emphasizes that opioids should not be the first-line option to treat chronic pain. The new recommendations in the guideline are voluntary, rather than prescriptive standards, and clarify that clinicians should consider the circumstances and unique needs of each patient when providing care.

    The draft guideline is available and open for public comment through April 11.