New CDC Opioid Guidelines Incite Backlash from Patient Groups

New CDC Opioid Guidelines Incite Backlash from Patient Groups – The Alliance for Patient Access by Amanda Conschafter,

From the Alliance for Patient Access, a national network of physicians dedicated to ensuring patient access to approved therapies and appropriate clinical care.

The Centers for Disease Control and Prevention has drafted new guidelines on prescribing opioids for chronic pain—and they could be bad news for patients living with pain. Released via webinar last week, the CDC’s guidelines have unsettled patients and incited controversy for a number of reasons  

1. CDC guidelines overlook the legitimate medical need of patients with chronic pain.

The guidelines focus almost solely on reducing abuse—identifying non-pharmacological treatment as “preferred” and advising reduced dosages for patients who rely on opioid pain medications to manage chronic pain.

In a joint letter from patient advocacy organizations to CDC leadership, signers explained that, “By addressing only how to limit or avoid opioids, the new guidelines will inevitably result in fewer prescriptions overall – including those needed by patients with legitimate medical needs. Chronic pain advocacy organizations hear daily from increasing numbers of constituents who are not being able to access the opioid medications they’ve relied on to live with their chronic painful conditions.”

2. CDC’s development process lacked transparency.

Slides used in the CDC’s webinar did not provide the names and affiliations of those who worked to promulgate the guidelines. As the aforementioned letter described, “The [webinar] presenters refused to provide any information other than to read exactly what was written on the slides even when asked directly by audience members to disclose the processes and people who had developed these prescribing guidelines.”

The CDC has not provided the public a list of the Core Expert Group members who assembled the guidelines.

3. CDC guidelines do not acknowledge FDA process and guidance.

The Food and Drug Administration requires safety and efficacy data for all medications, including the opioid pain medications it has approved. The FDA also approves an information insert to guide physicians in prescribing approved medications. By creating its own recommended daily maximum doses, the CDC effectively disparages FDA’s expertise.

4. CDC guidelines advise on minimizing the risk of abuse, but offer physicians little direction on helping patients manage their pain.

As patient advocates explained, “We need CDC to provide some context around the incidence and prevalence of undertreated pain and the related adverse consequences of undertreated chronic pain on all body systems. With these insights it may actually be possible to improve pain care rather than restricting one treatment based on perceived, not quantified, harms to legitimate patients.”

CDC’s complete guidelines are not available publicly, but a summary can be accessed on CDC’s website.  

 

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5 thoughts on “New CDC Opioid Guidelines Incite Backlash from Patient Groups

  1. painkills2

    A lot of anti-drug groups don’t like the FDA and think it’s not doing a good job, apparently including the CDC. Neither agency has a great track record, and like all other government agencies, there’s a revolving door and many conflicts of interest.

    But I think the FDA does the best job it can, considering its limitations. The agency moves slowly because bureaucracy moves slowly. The FDA makes mistakes because people make mistakes (and some corporations — I mean, people — make mistakes for financial gain). An internet meme sums it up by pointing out that every drug the FDA removes from the market (or assigns a new black box warning) was first approved by that very same agency.

    Patients are probably better defined as guinea pigs, not educated consumers of health care.

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    1. Dave

      What hypocrits CPATF is- they chose to hog the debate with regard to the national pain strategy- and exclude the voices of millions outside their membership- no when the CDC gives them a taste of their own medicine- they dont like it. If the pain specialists and these groups didnt exclude so many from being heard- maybe the groups in the cdc wouoldnt have become so reactionary.

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      1. Zyp Czyk Post author

        Once again, everyone is talking about opioids except pain patients themselves.

        And because they are not pain patients, they haven’t a clue about the positives of opioids.

        They don’t even realize they’re only thinking about drug abuse and addiction, and not at all about people with pain.

        It’s apparent that people without pain literally cannot imagine what it’s like, how critical it becomes to get relief in any way possible. Opioids are far from ideal, but they are the BEST we’ve got.

        I’d happily sacrifice 10, even 20, years of my life to live pain free. Life with untreated pain is torture and those withholding relief are torturers.

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  2. Dave

    No doubt some believe opioids are the best for pain-and maybe for some people in pain they are. But it is clear many have used opioids and either found no benefit or the side effects outweighed the good they did for them. I have said let access to pain treatments-whether they are opioids or scs or marijuana be easy and affordable-lets have people take control and responsibility for their pain care choices- to do otherwise is too costly, too burdensome too unfair-and doesnt build the capacity of people in pain to make good choices.
    When i lpulled a mucle in my back in 1999- the pain was very bad-i did not think of a pain medicine- but i did find a chiro to fix me.IF i had severe pain like that on a regular basis- i would be too distracted to do anything productive-and so i might chosen a pain med-nonetheless- i would have sought a more permanent solution as i would have been afraid to live with such an overwhelming condition. Perhaps my tolerance for pain is worse then others-perhaps i am luckier then others in finding solution to my pain. In any event though i am pain free i still look for solutions for others almost everyday. A practical solution for the pain of some opioids certainly are but no ideal solution-and so since i am an idealist i seek the best solutions ppossible, Though i never have and never will try to coerce someone from taking an opioid for pain or any treatment they are set on- by the same token i dont see pills as the best solution.
    We have been the victim of generations of people who have failed to develop ideal solutions for people in pain-why continue a tradition of suboptimization. Why shouldnt our generation call for a departure from the past- and call for ideal solutions so that the next generation will benefit from our efforts and we can say we made the sacrifice for them. We can be the gamechangers and put the future on a new and better course. There are worse ways to live and die then to be an idealist sweating it out, reaching out into the unknown searching for better ways.
    Let those who are stuck on the past and present ways claim they are doing good and that they are right- i dont care- i for one will march into the darkness and into the unknown- id rather die that way then tell my God when that day comes that i was unwilling to try hard to find better ways for those suffering pain. And so next year my new book- pain care is not free-will seek to free people in pain who are willing to march into the unknow and free themselves from the stale present and past ways of pain care

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  3. DREW5000G

    Until you find another way to cure pain, leave the stale present and past ways in place. People are suffering chronic pain which can only be treated using the most hardcore pain relief and you cannot relate their pain with your back.Opiods are the best we have and has been around for centuries. Now much of society that have been betrayed by their govts find themselves using opiods to deal with everyday bs, and instead of working hard to seperate the abusers from the real patients in chronic pain everyone says hold the opiates they are bad. GET REAL

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