Doctors too “abrupt” as they apply Opioid Restrictions?

In 2016, the Centers for Disease Control and Prevention (CDC) in the USA implemented new guidelines for restrictions of opioid medications. Now, as the results of the restrictions are coming to light, the CDC is expressing concern that doctors may be taking the restrictions too far.

It’s not surprising that the media attention on opioids has led to a bit of an overreaction. Although the evidence generally does suggest that prescriptions of opioids could be cut down drastically, it’s also true that they’ve helped a lot of people. Prescribing them when they’re helpful, and not rushing to get people off them, are two important concerns.

Three of the original authors of the restrictions published an article in the New England Journal of Medicine explaining:

Unfortunately, some policies and practices purportedly derived from the guideline have in fact been inconsistent with, and often go beyond, its recommendations. A consensus panel has highlighted these inconsistencies,⁵ which include inflexible application of recommended dosage and duration thresholds and policies that encourage hard limits and abrupt tapering of drug dosages, resulting in sudden opioid discontinuation or dismissal of patients from a physician’s practice. The panel also noted the potential for misapplication of the recommendations to populations outside the scope of the guideline.

No Shortcuts to Safer Opioid Prescribing

Although it’s certainly important to encourage patients to change when there are better treatment options, even the changes need to be done wisely. Dr. Patrice A. Harris, President-elect of the AMA and chair of the AMA Opioid Task Force, pointed out that the guidelines have been “wrongly treated as hard-and-fast rules, leaving physicians unable to offer the best care for their patients.” (source How the CDC’s opioid prescribing guidance went astray)

In the midst of all the concern about opioid overuse and overdose, doctors need to remember to put their patients first, and take a long term view.

For more information: CDC Admits Its Opioid Prescribing Guidelines Have Hurt Chronic Pain Patients