As part of the urgent response to the epidemic of overdose deaths, the Centers for Disease Control and Prevention (CDC) issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. The CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 will help primary care providers ensure the safest and most effective treatment for their patients.

While prescription opioids can be part of effective pain management, they have serious risks. The new guideline aims to improve the safety of prescribing and curtail the harms associated with opioids, including opioid use disorder and overdose. The guideline also focuses on increasing the use of other effective treatments available for chronic pain, such as nonopioid medications or physical therapy.

In developing the guideline, CDC followed a rigorous scientific process using the best available scientific evidence, consulting with experts, and listening to comments from the public and partners. CDC is dedicated to working with partners to improve the evidence base, and will refine recommendations as better evidence is available.

Among the 12 recommendations in the guideline, three principles are key to improving patient care:

1) Nonopioid therapy is preferred for chronic pain outside of active cancer, palliative, and end-of-life care.
2) When opioids are used, the lowest possible effective dosage should be prescribed to reduce risks of opioid use disorder and overdose.
3) Providers should always exercise caution when prescribing opioids and monitor all patients closely.

Health and Human Services Secretary Sylvia Burwell has made addressing opioid misuse, dependence, and overdose a priority. Other work on this important issue is underway within HHS. The evidence-based HHS-wide opioid initiative focuses on three priority areas: informing opioid prescribing practices, increasing the use of naloxone (a rescue medication that can prevent death from overdose), and expanding access to and the use of Medication-Assisted Treatment to treat opioid use disorder.

At the same time, the DWC is in the process of developing its own Opioid Treatment Guideline. The last public hearing on the DWC Guideline was in September, and the first fifteen day comment period ended last December. However, the DWC Guideline outlines a philosophical difference by stating “A key difference between occupational and non-occupational guidelines is that a main goal of the former is the restoration of function to ensure early return to work.”

It is clear that government at every level has recognized the opioid epidemic, and is responding with new Guideline initiatives. Time will tell if these efforts will be effective.