- In response to the growing epidemic of opioid abuse, the Center for Disease Control and Prevention's (CDC) unveiled new guidance on opioid prescribing. The guidelines recommend physicians first turn to NSAIDS such as ibuprofen when a patient presents with pain.
- In the event opioids are prescribed, the CDC also instructed physicians to prescribe the lowest dose for the shortest period of time, with a target window of three to seven days.
- These guidelines are not intended to cover patients with active cancer or those who are receiving palliative or end-of-life care. They are also voluntary.
The new guidance from the CDC is aimed specifically at primary care physicians, who write many of the opioids prescriptions in order to address their patients' acute or chronic pain.
Over-prescribing is thought to have factored into the steadily increasing rate of opioid abuse in the U.S. Twenty percent of all patients who present to a physician with non-cancer-related pain walk away with an opioid prescription. In 2012, doctors wrote a total of 259 million prescriptions for opioid medications.
Barry Mennen, MD, a Washington, D.C.-based primary care physician who focuses on weight loss and overall health, has prescribed his share of opioids, although he says he is generally careful. Nonetheless, Mennen said "the new guidelines will definitely change my prescribing behavior.”
"These guidelines give us generalists more cover. That means I can explain to patients why I really cannot write more than a few days of heavy duty pain meds, and that if they feel that's what they need they must see a pain specialist. I don't mind covering people for a few days—but longer than that, I am uncomfortable."
In fact, many patients may be pushed more towards specialists now, and critics of the CDC guidelines say many patients now face being under-treated for their pain. Others have suggested that the guidance is not well-substantiated.
The CDC suggests that in addition to NSAIDs, other interventions, such as physical therapy and exercise may be helpful.