How would opioid prescription guidelines read if pain patients wrote them?

A CDC Guideline for prescribing opioids in chronic pain was published in March 2016. It has become clear that this Guideline is generating horrendously negative results for both chronic pain patients and their doctors. Many doctors are choosing to leave pain management rather than face possible prosecution by State or Drug Enforcement Agency authorities for over-prescription of pain relieving opioids. Tens (if not hundreds) of thousands of patients are being summarily discharged without referral and sometimes without management of opioid withdrawal. There are increasing reports of patient suicides. Many professionals in medicine have published sharply critical reviews of the problems of the CDC Guideline. Also of deep concern are proposals by the US Centers for Medicare and Medicaid to make the Guideline a mandatory standard for insurance reimbursement. Many believe that the Guideline was deeply influenced by an anti-opioid bias on the part of key writers on the CDC Working Group which authored it. Even more damaging have been revelations that medical evidence assembled in support of the work was manipulated to discredit opioid reliability and over-magnify risks. As one group of medical professionals phrased the issues, the CDC Guidelines are “neat, plausible, and generally wrong.”

Author(s): Richard A Lawhern

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