Problems with CDC Guideline Implementation

Challenges with Implementing the Centers for Disease Control and Prevention Opioid Guideline: A Consensus Panel Report | Pain Medicine | Oxford Academic – Jan 2019

Background

A national crisis of opioid-related morbidity, mortality, and misuse has led to initiatives to address the appropriate role of opioids to treat pain.

Deployment of a guideline from the Centers for Disease Control and Prevention to reduce the risks of opioid therapy has raised substantial clinical and public policy challenges.

“Challenges” is bureaucrat-speak for “problems”.  

The agency anticipated implementation challenges and committed to reevaluating the guideline for intended and unintended effects on clinician and patient outcomes.

But the CDC has made no effort or even mention of the growing disaster caused by its guidelines.

Part of that guideline stated that it would be necessary to study and evaluate the effects of its implementation, but the CDC is ignoring its own advice on this point.

Observations

A multidisciplinary expert panel met to review the influence of the core recommendations of the guideline on pain management practices, principally regarding the estimated 5 to 8 million Americans with chronic pain currently on opioids

The panel identified implementation challenges, including

• application of dosage ceilings and prescription duration guidance,
• failure to appreciate the importance of patient involvement in decisions to taper or discontinue opioids,
• barriers to diagnosis and treatment of opioid use disorder, and
• impeded access to recommended comprehensive, multimodal pain care

Furthermore, policy-making and regulatory bodies may misapply guideline recommendations without flexibility and, sometimes, without full awareness of what the guideline contains.

The panel largely supported the guideline, endorsing its focal points of safety and comprehensive assessment and monitoring.

To mitigate clinical and policy challenges identified with implementing the guideline, the panel discussed areas where viewpoints diverged and arrived at consensus proposals.

The target audience includes the leaders and institutions that create policy and influence guideline implementation to include regulatory agencies, legislators, public and private payers, and health care systems.

Mealy mambo-jumbo – almost like a teaser to buy and read the full article.

They characterize the “results” of their “study”, only to tell you what exactly you will have to buy the paper to see.

Another example of the disgusting profiteering in the biological sciences these days.