AMA seeks to revise CDC guidelines for opioid prescribing


The American Medical Association is urging the Centers for Disease Control and Prevention to revise their 2016 opioid prescribing guidelines. The organization says the guidelines restrict patients’ access to pain relievers.

IN letter The AMA, sent to the CDC on Thursday, said the agency’s landmark prescribing guidelines issued in response to the opioid crisis does not take into account how the epidemic has developed. Drug overdose deaths rose 30% from 2019 to 2020 to a record 93,000, despite prescription drug restrictions becoming widespread among most healthcare providers since the guidelines were issued.

The trend was fueled by illicit sales of fentanyl, which accounted for 60% of overdose deaths in 2020. CDC data… Experts warn that the mental anguish caused by the pandemic, combined with months of limited access to personal drug dependence treatment services, is likely to lead to an increase in drug use among those at higher risk.

This letter is the latest call from the AMA to change guidelines… For years, the group argued that CDC’s prescribing guidelines, designed to help primary care physicians make opioid prescribing decisions for adult patients with chronic pain, have been misapplied and used as a premise for wider prescribing ranges. than intended.

This has been admitted by the CDC itself. The authors of the CDC recommendations in a 2019 comment published in New England Journal of Medicine cautioned against using the recommendations in a way that could potentially harm patients, such as setting dose thresholds that could lead doctors to abruptly shut off patients or reduce dose levels too quickly.


“The CDC’s Threshold Guidelines are still being used against patients in pain to refuse treatment,” wrote Dr. Bobby Mukkamala, chairman of the AMA’s board of trustees, in a letter to the CDC. “We know it has affected cancer patients, sickle cell disease and hospice patients – restrictive policies have also been letting down patients who are consistently receiving opioid therapy.”

Since the guidelines were issued, many health systems have sought to change their pain management practices by limiting the exposure of patients to prescription opioids in favor of less addictive alternative therapies such as acetaminophen and ibuprofen for post-operative recovery.

According to a study published in April in the journal News, the CDC’s recommendations were associated with a reduction in postoperative dispensing of opioids within two years of their release, compared to two years before their publication. Journal of the American Medical Association

Some of the AMA’s comments on the guidelines were acknowledged in report released earlier this month by a CDC working group tasked with reviewing possible changes to prescribing guidelines.

While the report states that several members of the working group “expressed concern” about some of the recommendations, others expressed concern about the possible “over-fixing” of identified guidelines issues to the point that it could be detrimental to the overall outcome.

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