CDC updates guideline on prescribing opioids for pain management
The guideline covers recommendations for primary care and other clinicians managing pain in outpatient settings and after patients are discharged from hospitals, EDs, or other facilities.
The CDC recently updated its guideline on outpatient prescribing of opioids for pain management.
The new clinical practice guideline replaces the agency's 2016 report and addresses four main areas: determining whether or not to initiate opioids for pain, selecting opioids and determining opioid dosages, deciding duration of initial opioid prescription and conducting follow-up, and assessing risk and addressing potential harms of opioid use. The guideline covers recommendations for primary care and other clinicians managing pain in outpatient settings and after patients are discharged from hospitals, EDs, or other facilities. Twelve recommendations are included, several of which are new or apply updated research, and involve management of pain that is acute (less than one month), subacute (from one to three months), or chronic (lasting more than three months). Implementation considerations for each recommendation are also provided. The guideline was published in the Nov. 4 MMWR.
Some of the key changes in the guideline were described by CDC officials in a Perspective article published by the New England Journal of Medicine on Nov. 3, including a new recommendation to maximize use of nonopioid therapies as appropriate for patients' conditions and guidance on working with patients already receiving opioids to determine whether and how to taper them.
“The 2022 guideline aims to promote equitable access to effective, informed, individualized, and safe pain management that improves patients' function and quality of life, while clarifying and reducing the risks associated with opioid use,” the Perspective authors wrote. “Ideally, new recommendations should result in greater and more equitable access to the full range of evidence-based treatments for pain, more judicious initial use of opioids, and more careful consideration and management of benefits and risks associated with continuing, tapering, or discontinuing opioids in patients who are already receiving them long term.”