CDC’s new opioid guidance could ease pain for patients, but it could be too late

When the CDC issued recommendations for opioid medications to combat substance abuse, it left thousands of patients suffering with chronic pain suddenly unable to get medication.
New recommendations from the CDC loosen prescribing guidelines for opioid medications in an effort to help patients who need these medications get access.
Published: Nov. 4, 2022 at 5:58 PM EDT
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WILMINGTON, N.C. (WECT) - New recommendations from the Centers for Disease Control and Prevention loosen prescribing guidelines for opioid medications to help patients who need these medications get access to them.

Opioids can be essential medications for the management of pain, but they carry considerable potential risk for addiction. That’s what led to the CDC issuing guidelines for prescribers in 2016 limiting dosages and recommendations, but these guidelines had serious unintended consequences.

Cindy Steinberg, Director of Policy and Advocacy for the U.S. Pain Foundation, said the CDC’s recommendations led to significant problems for patients that rely on them to manage their disease — chronic pain. She said doctors and other healthcare providers saw these recommendations and many stopped providing these prescriptions, and that had serious impacts on those who need them.

“People were forced off of their medication. Many people were cut off, leading to withdrawal for people that had been on it a long time, not because they were addicted, but because their bodies become dependent on the medication,” she said.

The U.S. Pain Foundation is a non-profit that advocates for pain patients. The number of people impacted by the CDC’s report is in the millions.

“We have documented 20 million people with high impact — 20 million Americans with high impact chronic pain. It is affected hundreds of thousands of people that have been on opioids that have been summarily taken off of them,” Steinberg said.

In the latest guidelines, the CDC acknowledges that misuse of opioids is largely related to treating pain — not because of addiction.

“In 2020, among those reporting misuse during the past year, 64.6% reported the main reason for their most recent misuse was to “relieve physical pain” compared with 11.3% to “feel good or get high” and 2.3% “because I am hooked or have to have it.” Taken together, these factors underscore the need for an updated clinical practice guideline on appropriate opioid prescribing for pain and pain management,” the CDC report states.

While the CDC’s guidelines were aimed at reducing opioid addiction, their report had consequences and led to states implementing laws based on their recommendations.

“Although not the intent of the 2016 CDC Opioid Prescribing Guideline, design and implementation of new laws, regulations, and policies also appeared to reflect its recommendations,” according to the CDC’s newest recommendations.

Steinberg questioned why the CDC was even responsible for issuing these reports.

“If anyone should it’s the FDA, the FDA is responsible for dosage. You don’t hear the FDA coming out and saying we need to do a specific dosage. They would never do that. Right? Because it’s completely irresponsible. Sadly, this task of writing these guidelines was allowed to happen in CDC,” she said.

“What CDC should have done was when that report came out Congress mandated in 2019, that was created by pain management experts that was lauded by over 160 organizations. The AMA came out with a press release saying this is a fabulous report. CDC should have deferred to that report that talks about all the ways to manage pain and not taking it upon themselves.”

Steinberg said she believes there is too much focus on one part of treating pain instead of taking a holistic approach to treat it.

“I think we need to get away so much from this, you know, over-focus on opioids and understand that they have a place. And for some people, they really are the right thing who do well on them medically managed,” she said.

As for fixing the challenges that states have put into place by putting so much emphasis on opioids, Steinberg said it might be too late.

“I think the truth is that the horses are out of the barn already and that I don’t think this is going to have too much of a correction. Because I think it’s too late. Sadly, you know, it’s hard to change laws,” she said.

However, she does believe that Congress should take a closer look at the report they mandated in 2019 and use it to guide the future of pain management and medications instead.

“Opioids are just one small, tiny part of a whole range of treatments for pain. And that is really the best way to manage pain,” she said.