He said the new CDC guidance reflects “an extraordinary amount of input” from chronic pain patients and their doctors but doubts it will have much of an impact if the FDA and the Drug Enforcement Administration don’t change how they enforce federal laws. Stefan Kertesz, a professor of medicine at the University of Alabama-Birmingham. But drug tapering is associated with deaths from overdose and suicide, with risk increasing the longer a person had been taking opioids, according to research by Dr. Multiple studies question whether opioids are the most effective way to treat chronic pain in the long term. “I hope we just continue to spread caution without spreading too much fear about never using opioids,” said Perrone, who helped craft the CDC’s latest recommendations.Ĭhristopher Jones, director of the CDC’s National Center for Injury Prevention and Control, said the updated recommendations are not a regulatory mandate but only a tool to help doctors “make informed, person-centered decisions related to pain care.” Jeanmarie Perrone, director of the Penn Medicine Center for Addiction Medicine and Policy. Taking into account the perspective of chronic pain patients, the latest recommendations try to scale back some of the harms to people who had benefited from opioids but were cut off, said Dr. The CDC says illicit fentanyl has fueled a recent surge in overdose deaths. in the past two decades, with a spike early in the covid-19 pandemic. Opioid overdose deaths have risen steadily in the U.S. The human toll of the opioid crisis is hard to overstate. The 2022 revisions are “a dramatic change,” he said. Physicians reduced the number of opioid pills they prescribe after surgeries, he said. Bobby Mukkamala, chair of the American Medical Association’s Substance Use and Pain Care Task Force. The first CDC guidelines “put everybody on notice,’’ said Dr. The dozens of laws that states passed limiting how providers prescribe or dispense those medications, she said, had an effect: a decline in opioid prescriptions even as overdoses continued to climb. Pooja Lagisetty, an assistant professor of medicine at the University of Michigan Medical School. The 2016 guidelines for prescribing opioids to people with chronic pain filled a vacuum for state officials searching for solutions to the overdose crisis, said Dr. The reasons include a lack of coordination from other federal agencies, fear of legal consequences among providers, state policymakers hesitant to tweak laws, and widespread stigma surrounding opioid medication. The new standards also warn doctors about risks associated with rapid dose changes after long-term use.īut some doctors worry the new recommendations will take a long time to make a meaningful change - and may be too little, too late for some patients. While the guidelines still say opioids should not be the go-to option for pain, they ease recommendations about dose limits, which were widely viewed as hard rules in the CDC’s 2016 guidance. In November, the agency released new guidelines, encouraging physicians to focus on the individual needs of patients. The recommendations left many patients grappling with the mental and physical health consequences of rapid dose tapering or abruptly stopping medication they’d been taking for years, which carries risks of withdrawal, depression, anxiety, and even suicide. “But the federal crackdowns and guidelines have created collateral damage: patients left high and dry.”īorn of an effort to fight the nation’s overdose crisis, the guidance led to legal restrictions on doctors’ ability to prescribe painkillers. “We had a massive opioid problem that needed to be rectified,” said Antonio Ciaccia, president of 3 Axis Advisors, a consulting firm that analyzes prescription drug pricing.
The CDC recently updated those recommendations to try to ease their impact, but doctors, patients, researchers, and advocates say the damage is done. Many have struggled to get opioid prescriptions written and filled since 2016 guidelines from the Centers for Disease Control and Prevention inspired laws cracking down on doctor and pharmacy practices. Layman is one of the millions in the U.S. “If something should happen to him, there’s nowhere for me to go,” she said.
She hopes her current doctor won’t do the same. The latest phone calls came late last year, after her previous doctor shuttered his pain medicine practice, she said. But she said nothing worked as well as methadone, an opioid she has taken since 2013. Layman has tried a host of non-opioid treatments to help with the intense daily pain caused by double scoliosis, a collapsed spinal disc, and facet joint arthritis.